{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:18:59Z","timestamp":1792509539960,"version":"4.5.0"},"reference-count":100,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Dysregulated hemostasis in cancer patients is associated with various clinical conditions, from thromboembolic complications to disseminated intravascular coagulation. Despite the well-established association between cancer and thromboembolic complications, the mechanisms involved are not completely elucidated. There are several predisposing factors in cancer for increased thrombus generation, such as immobilization and chemotherapy. The term cancer-associated thrombosis (CAT) has been introduced to describe the close bidirectional relationship between cancer and thromboembolic events. Conventional coagulation tests (PT\/aPTT) are more accurate in detecting a hypocoagulable rather than a hypercoagulable state; thus, their contribution to CAT management is limited. Traditionally, D-dimer levels have been the most common laboratory study for the evaluation of thrombotic risk. However, D-dimer levels only display a snapshot of the coagulation cascade, and they cannot provide a dynamic evaluation of evolving clot formation. Non-conventional assays, such as viscoelastic methods and microparticle formation are promising tools for the identification of patients at risk for developing CAT. Recent guidelines from the American Society of Clinical Oncology counsel against the estimation of thrombotic risk through a single test and recommend the use of scoring systems that take into account several risk factors. The present review outlines the current insights into the pathophysiological mechanisms of CAT and provides a comprehensive review of the latest advances in the laboratory assessment of CAT and the recent guidelines for the management of patients at risk for developing thromboembolic complications.<\/jats:p>","DOI":"10.3390\/cancers16112082","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:42:34Z","timestamp":1717065754000},"page":"2082","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Cancer-Associated Thrombosis: Pathophysiology, Laboratory Assessment, and Current Guidelines"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-0759","authenticated-orcid":false,"given":"Andreas G.","family":"Tsantes","sequence":"first","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"},{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Petrou","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina A.","family":"Tsante","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-8901","authenticated-orcid":false,"given":"Rozeta","family":"Sokou","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, \u201cAgios Panteleimon\u201d General Hospital of Nikea, 18454 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3897-6282","authenticated-orcid":false,"given":"Frantzeska","family":"Frantzeskaki","sequence":"additional","affiliation":[{"name":"2nd Department of Critical Care, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aglaia","family":"Domouchtsidou","sequence":"additional","affiliation":[{"name":"Microbiology Department, \u201cSaint Savvas\u201d Oncology Hospital, 11522 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios E.","family":"Chaldoupis","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios P.","family":"Fortis","sequence":"additional","affiliation":[{"name":"Laboratory of Reliability and Quality Control in Laboratory Hematology (HemQcR), Department of Biomedical Sciences, Section of Medical Laboratories, School of Health & Caring Sciences, University of West Attica (UniWA), 12243 Egaleo, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1414-6639","authenticated-orcid":false,"given":"Daniele","family":"Piovani","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3307-0246","authenticated-orcid":false,"given":"Georgios K.","family":"Nikolopoulos","sequence":"additional","affiliation":[{"name":"Medical School, University of Cyprus, 2029 Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Iacovidou","sequence":"additional","affiliation":[{"name":"Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-6579","authenticated-orcid":false,"given":"Stefanos","family":"Bonovas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy"},{"name":"IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Samonis","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Crete, 71500 Heraklion, Greece"},{"name":"Department of Oncology, Metropolitan Hospital, 18547 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyrios E.","family":"Tsantes","sequence":"additional","affiliation":[{"name":"Laboratory of Haematology and Blood Bank Unit, \u201cAttiko\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1016\/S0049-3848(14)50012-6","article-title":"Cancer-related coagulopathies","volume":"133","author":"Levi","year":"2014","journal-title":"Thromb. 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