{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:00:43Z","timestamp":1780290043869,"version":"3.54.0"},"reference-count":78,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"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>Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in patients with cancer. The management of special situations\u2014including recurrent venous thromboembolism (VTE), thrombosis at unusual sites, and central venous catheter-associated thrombosis (CVC-AT)\u2014remains particularly challenging because of the limited availability of high-quality evidence. This narrative review synthesizes recommendations from major international and Spanish clinical practice guidelines and expert consensus documents, including those from SEOM, ESMO, ASCO, NCCN, ITAC and SEMI, to provide a structured framework for the management of these complex scenarios. Our analysis identified substantial heterogeneity across guidelines, particularly regarding anticoagulant selection, dosing strategies, and treatment duration. Although some convergence exists in the management of CVC-AT, important discrepancies and evidence gaps persist in areas such as splanchnic vein thrombosis, hepatic impairment, central nervous system involvement, and recurrent VTE despite treatment. In many cases, recommendations are based primarily on expert opinion rather than robust trial data, and several clinical scenarios are addressed by only a limited number of guidelines. These findings underscore the need for more standardized management strategies and prospective clinical studies to better inform decision-making in daily practice. Overall, this review highlights the growing importance of individualized anticoagulant management aimed at balancing thrombotic and bleeding risks in high-risk oncology patients, thereby helping to bridge the gap between expert consensus and evidence-based precision anticoagulation.<\/jats:p>","DOI":"10.3390\/cancers18111707","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:30:33Z","timestamp":1779669033000},"page":"1707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anticoagulation for Cancer Patients in Special Situations: A Narrative Review of Guidelines and Literature"],"prefix":"10.3390","volume":"18","author":[{"given":"Pilar","family":"Sotoca Rubio","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Serrano Domingo","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Vithas La Milagrosa University Hospital, 28010 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Guerrero Serrano","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7739-4413","authenticated-orcid":false,"given":"Patricia","family":"P\u00e9rez de Aguado Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7636-4765","authenticated-orcid":false,"given":"Ana Mar\u00eda","family":"Barrill Corpa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Infanta Leonor University Hospital, 28031 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Moreno Doval","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1342-9653","authenticated-orcid":false,"given":"Coral","family":"Garc\u00eda de Quevedo Suero","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-5363","authenticated-orcid":false,"given":"Juan Carlos","family":"Calvo P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Gonz\u00e1lez-Merino","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Gonz\u00e1lez Mart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Chamorro P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"G\u00f3mez Rueda","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Pr\u00edncipe de Asturias University Hospital, 28805 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5899-6125","authenticated-orcid":false,"given":"Pilar","family":"Garrido L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ramon y Cajal University Hospital, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1007\/s12094-024-03605-2","article-title":"SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023)","volume":"26","year":"2024","journal-title":"Clin. Transl. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annonc.2022.12.014","article-title":"Venous thromboembolism in cancer patients: ESMO Clinical Practice","volume":"34","author":"Falanga","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1470-2045(22)00160-7","article-title":"2022 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19","volume":"23","author":"Farge","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_4","unstructured":"(2026, February 04). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae). Cancer-Associated Venous Thromboembolic Disease. Version 3.2025. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/vte.pdf."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e373","DOI":"10.1055\/s-0038-1675577","article-title":"Cancer-Associated Thrombosis: Beyond Clinical Practice Guidelines-A Multidisciplinary (SEMI-SEOM-SETH) Expert Consensus","volume":"2","author":"Gallardo","year":"2018","journal-title":"TH Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.rce.2024.09.003","article-title":"2024 Spanish Society of Internal Medicine (SEMI) recommendations for the management of cancer-associated venous thromboembolism","volume":"225","author":"Villalobos","year":"2025","journal-title":"Rev. Cl\u00edn. Esp."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e774","DOI":"10.1161\/CIR.0000000000000707","article-title":"Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence A Scientific Statement from the American Heart Association","volume":"140","author":"Giri","year":"2019","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1200\/JCO.19.01461","article-title":"Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: ASCO Clinical Practice Guideline Update","volume":"38","author":"Key","year":"2020","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.23.00294","article-title":"Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: ASCO Guideline Update abstract","volume":"41","author":"Key","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.ejim.2022.02.020","article-title":"Consensus on prevention and treatment of cancer-associated thrombosis (CAT) in controversial clinical situations with low levels of evidence","volume":"100","author":"Gallardo","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3932","DOI":"10.1016\/j.jtha.2025.08.022","article-title":"Management of recurrent venous thromboembolism during anticoagulant treatment in patients with cancer: A prospective cohort study","volume":"23","author":"Lanting","year":"2025","journal-title":"J. Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Rosson, M., D\u2019Oria, M., Simion, C., Simioni, P., and Campello, E. (2025). Critical Review of International Clinical Practice Guidelines Recommendations for Prevention, Diagnosis, and Management of Central Venous Catheter Thrombosis. Thromb. Haemost., Available online: https:\/\/www.thieme-connect.com\/products\/ejournals\/abstract\/10.1055\/a-2649-9451.","DOI":"10.1055\/a-2649-9451"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/eurjpc\/zwab088","article-title":"Second consensus document on diagnosis and management of acute deep vein thrombosis: Updated document elaborated by the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function","volume":"29","author":"Mazzolai","year":"2022","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ejvs.2020.09.023","article-title":"Editor\u2019s Choice\u2014European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis","volume":"61","author":"Kakkos","year":"2021","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.chest.2024.03.003","article-title":"Antithrombotic Therapy for VTE Disease: Compendium and Review of CHEST Guidelines 2012-2021","volume":"166","author":"Stevens","year":"2024","journal-title":"Chest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/j.1365-2141.2012.09249.x","article-title":"Guidelines on the investigation and management of venous thrombosis at unusual sites","volume":"159","author":"Tait","year":"2012","journal-title":"Br. J. Haematol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zaccone, V., Santoro, L., Guerrieri, E., Diblasi, I., Roncarati, I., Viticchi, G., Vecchiarelli, P., Santoliquido, A., Fiore, F., and Molfino, A. (2023). Prevention and treatment of catheter-related venous thrombosis in long-term parenteral nutrition: A SINuC position statement. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1106327"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.clnu.2009.03.015","article-title":"ESPEN Guidelines on Parenteral Nutrition: Central Venous Catheters (access, care, diagnosis and therapy of complications)","volume":"28","author":"Pittiruti","year":"2009","journal-title":"Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3226","DOI":"10.1182\/bloodadvances.2018024828","article-title":"American Society of Hematology 2018 guidelines for management of venous thromboembolism: Diagnosis of venous thromboembolism","volume":"2","author":"Lim","year":"2018","journal-title":"Blood Adv."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of Hematology 2021 guidelines for management of venous thromboembolism: Prevention and treatment in patients with cancer","volume":"5","author":"Lyman","year":"2021","journal-title":"Blood Adv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"483","DOI":"10.6004\/jnccn.2024.0046","article-title":"Cancer-Associated Venous Thromboembolic Disease, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology","volume":"22","author":"Streiff","year":"2024","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1200\/JCO.2012.45.5733","article-title":"Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline","volume":"31","author":"Schiffer","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/jth.12527","article-title":"Catheter-associated deep vein thrombosis of the upper extremity in cancer patients: Guidance from the SSC of the ISTH","volume":"12","author":"Zwicker","year":"2014","journal-title":"J. Thromb. Haemost."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/jth.12071","article-title":"International clinical practice guidelines for the treatment and prophylaxis of thrombosis associated with central venous catheters in patients with cancer","volume":"11","author":"Debourdeau","year":"2013","journal-title":"J. Thromb. Haemost."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s12094-019-02263-z","article-title":"SEOM clinical guideline of venous thromboembolism (VTE) and cancer (2019)","volume":"22","year":"2020","journal-title":"Clin. Transl. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1093\/annonc\/mdp052","article-title":"2008 SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: Report from the working group","volume":"20","author":"Debourdeau","year":"2009","journal-title":"Ann. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/anae.13360","article-title":"Association of Anaesthetists of Great Britain and Ireland: Safe vascular access 2016","volume":"71","author":"Babu","year":"2016","journal-title":"Anaesthesia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/aas.12295","article-title":"Clinical guidelines on central venous catheterisation: Central venous catheterisation","volume":"58","author":"Frykholm","year":"2014","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_29","first-page":"CD006650","article-title":"Anticoagulation for the long-term treatment of venous thromboembolism in people with cancer","volume":"6","author":"Kahale","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e17894","DOI":"10.1097\/MD.0000000000017894","article-title":"The anticoagulants rivaroxaban and low molecular weight heparin prevent PICC-related upper extremity venous thrombosis in cancer patients","volume":"94","author":"Lv","year":"2019","journal-title":"Medicine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/jth.14662","article-title":"Apixaban and dalteparin in active malignancy-associated venous thromboembolism: The ADAM VTE trial","volume":"18","author":"McBane","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1177\/1076029606293692","article-title":"Secondary Prevention of Venous Thromboembolic Events in Patients with Active Cancer: Enoxaparin Alone Versus Initial Enoxaparin Followed by Warfarin for a 180-Day Period","volume":"12","author":"Deitcher","year":"2006","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1056\/NEJMoa025313","article-title":"Low-Molecular-Weight Heparin versus a Coumarin for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer","volume":"349","author":"Lee","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lee, A.Y.Y., Bauersachs, R., Janas, M.S., Jarner, M.F., Kamphuisen, P.W., Meyer, G., and Khorana, A.A. (2013). CATCH: A randomised clinical trial comparing long-term tinzaparin versus warfarin for treatment of acute venous thromboembolism in cancer patients. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-284"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1056\/NEJMoa1711948","article-title":"Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism","volume":"378","author":"Raskob","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1200\/JCO.2018.78.8034","article-title":"Comparison of an Oral Factor Xa Inhibitor with Low Molecular Weight Heparin in Patients with Cancer with Venous Thromboembolism: Results of a Randomized Trial (SELECT-D)","volume":"36","author":"Young","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer","volume":"382","author":"Agnelli","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1001\/archinte.162.15.1729","article-title":"Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: A randomized controlled study","volume":"162","author":"Meyer","year":"2002","journal-title":"Arch. Intern. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"867","DOI":"10.7326\/0003-4819-140-11-200406010-00007","article-title":"Fondaparinux or Enoxaparin for the Initial Treatment of Symptomatic Deep Venous Thrombosis","volume":"140","author":"Davidson","year":"2004","journal-title":"Ann. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1056\/NEJMoa2416112","article-title":"Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism","volume":"392","author":"Carrier","year":"2025","journal-title":"N. Engl. J. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1007\/s12094-019-02159-y","article-title":"Bemiparin as a long-term treatment for venous thrombosis in cancer patients: The ELEBAMA study","volume":"22","author":"Pina","year":"2020","journal-title":"Clin. Transl. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1177\/1076029617753538","article-title":"Effectiveness and Safety of LMWH Treatment in Patients with Cancer Diagnosed with Non-High-Risk Venous Thromboembolism: Turkish Observational Study (TREBECA)","volume":"24","author":"Ozaslan","year":"2018","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"6196","DOI":"10.1002\/cam4.3269","article-title":"Rivaroxaban thromboprophylaxis in ambulatory patients with pancreatic cancer: Results from a pre-specified subgroup analysis of the randomized CASSINI study","volume":"9","author":"McNamara","year":"2020","journal-title":"Cancer Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1056\/NEJMoa1814630","article-title":"Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer","volume":"380","author":"Khorana","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1056\/NEJMoa1814468","article-title":"Apixaban to Prevent Venous Thromboembolism in Patients with Cancer","volume":"380","author":"Carrier","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/S1470-2045(09)70232-3","article-title":"Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: A randomised, placebo-controlled, double-blind study","volume":"10","author":"Agnelli","year":"2025","journal-title":"Lancet Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1111\/j.1538-7836.2010.03901.x","article-title":"Prevention of venous thromboembolism in patients with advanced lung cancer receiving chemotherapy: A combined analysis of the PROTECHT and TOPIC-2 studies","volume":"8","author":"Verso","year":"2010","journal-title":"J. Thromb. Haemost."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/1076029611433769","article-title":"Low-molecular-weight heparin versus placebo for the prevention of venous thromboembolism in metastatic breast cancer or stage III\/IV lung cancer","volume":"18","author":"Haas","year":"2012","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1200\/JCO.2014.55.1481","article-title":"Efficacy of Prophylactic Low\u2013Molecular Weight Heparin for Ambulatory Patients with Advanced Pancreatic Cancer: Outcomes From the CONKO-004 Trial","volume":"33","author":"Pelzer","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"102172","DOI":"10.1016\/j.rpth.2023.102172","article-title":"Acute venous thromboembolism in patients with brain cancer: Clinical course","volume":"7","author":"Becattini","year":"2023","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"4873","DOI":"10.1182\/bloodadvances.2022008086","article-title":"ICH in primary or metastatic brain cancer patients with or without anticoagulant treatment: A systematic review and meta-analysis","volume":"6","author":"Giustozzi","year":"2022","journal-title":"Blood Adv."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1160\/TH16-09-0680","article-title":"Outcomes of low-molecular-weight heparin treatment for venous thromboembolism in patients with primary and metastatic brain tumours","volume":"117","author":"Linkins","year":"2017","journal-title":"Thromb. Haemost."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jtha.2025.10.022","article-title":"Mechanisms and treatment of venous thromboembolism in patients with brain cancer: A narrative review","volume":"24","author":"Hoberstorfer","year":"2026","journal-title":"J. Thromb. Haemost."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1111\/jth.13387","article-title":"A meta-analysis of intracranial hemorrhage in patients with brain tumors receiving therapeutic anticoagulation","volume":"14","author":"Zwicker","year":"2016","journal-title":"J. Thromb. Haemost."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1182\/blood-2015-02-626788","article-title":"Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: A matched cohort study","volume":"126","author":"Donato","year":"2015","journal-title":"Blood"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e01638","DOI":"10.1002\/brb3.1638","article-title":"Risk of intracranial bleeding in patients with primary brain cancer receiving therapeutic anticoagulation for venous thromboembolism: A meta-analysis","volume":"10","author":"Porfidia","year":"2020","journal-title":"Brain Behav."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"107243","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107243","article-title":"Risk of intracranial hemorrhage with direct oral anticoagulation versus low molecular weight heparin in the treatment of brain tumor-associated venous thromboembolism: A meta-analysis","volume":"32","author":"Yang","year":"2023","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/jth.14336","article-title":"Intracranial hemorrhage with direct oral anticoagulants in patients with brain tumors","volume":"17","author":"Carney","year":"2019","journal-title":"J. Thromb. Haemost."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1182\/blood.2023023450","article-title":"How I treat acute venous thromboembolism in patients with brain tumors","volume":"144","author":"Leader","year":"2024","journal-title":"Blood"},{"key":"ref_60","unstructured":"(2026, February 04). Fondaparinux. Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/arixtra-epar-product-information_en.pdf."},{"key":"ref_61","unstructured":"(2026, February 04). Enoxaparin. Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/inhixa-epar-product-information_en.pdf."},{"key":"ref_62","unstructured":"(2026, February 04). Tinzaparina. Ficha T\u00e9cnica en Indicaci\u00f3n en Tratamiento [Tinzparin. Summary of Product Characteristics for Treatment Indications]. Available online: https:\/\/cima.aemps.es\/cima\/pdfs\/ft\/77153\/FT_77153.pdf."},{"key":"ref_63","unstructured":"(2026, February 04). Tinzaparina. Ficha T\u00e9cnica Indicaci\u00f3n en Profilaxis [Tinzparin. Summary of Product Characteristics for Prophylaxis Indications]. Available online: https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/77340\/FT_77340.html."},{"key":"ref_64","unstructured":"(2026, February 04). Bemiparina. Ficha T\u00e9cnica Indicaci\u00f3n en Tratamiento [Bemiparin. Summary of Product Characteristics for Treatment Indications]. Available online: https:\/\/cima.aemps.es\/cima\/pdfs\/es\/ft\/64166\/FichaTecnica_64166.html.pdf."},{"key":"ref_65","unstructured":"(2026, February 04). Bemiparina. Ficha T\u00e9cnica Indicaci\u00f3n en Profilaxis [Bemiparin. Summary of Product Characteristics for Prophylaxis Indications]. Available online: https:\/\/cima.aemps.es\/cima\/pdfs\/es\/ft\/61908\/FT_61908.html.pdf."},{"key":"ref_66","unstructured":"(2026, February 04). Dalteparina. Ficha T\u00e9cnica [Dalteparin. Summary of Product Characteristics]. Available online: https:\/\/cima.aemps.es\/cima\/dochtml\/ft\/58536\/FT_58536.html."},{"key":"ref_67","unstructured":"(2026, February 04). Apixaban. Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/eliquis-epar-product-information_en.pdf."},{"key":"ref_68","unstructured":"(2026, February 04). Rivaroxaban. Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/rivaroxaban-koanaa-epar-product-information_en.pdf."},{"key":"ref_69","unstructured":"(2026, February 04). Edoxab\u00e1n. Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/lixiana-epar-product-information_en.pdf."},{"key":"ref_70","unstructured":"(2026, February 04). Heparin Sodium. Summary of Product Characteristics, Available online: https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=eede8a0c-5ae6-4166-84b3-12081405f08e."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1177\/1060028019890028","article-title":"Cirrhosis, Thrombosis, Finding FaXts about Doses: Dosing of Unfractionated Heparin for Venous Thromboembolism in Cirrhosis","volume":"54","author":"Franz","year":"2020","journal-title":"Ann. Pharmacother."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/FTD.0000000000000105","article-title":"Comparison of anti-Xa and activated partial thromboplastin time monitoring for heparin dosing in patients with cirrhosis","volume":"37","author":"Fuentes","year":"2015","journal-title":"Ther. Drug Monit."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1111\/jth.15829","article-title":"Thromboprophylaxis for venous thromboembolism prevention in hospitalized patients with cirrhosis: Guidance from the SSC of the ISTH","volume":"20","author":"Roberts","year":"2022","journal-title":"J. Thromb. Haemost."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1177\/1060028018768449","article-title":"Enoxaparin Dosing at Extremes of Weight: Literature Review and Dosing Recommendations","volume":"52","author":"Sebaaly","year":"2018","journal-title":"Ann. Pharmacother."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.thromres.2004.10.004","article-title":"Dosage of enoxaparin among obese and renal impairment patients","volume":"116","author":"Bazinet","year":"2005","journal-title":"Thromb. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1538-7836.2004.01053.x","article-title":"The safety of dosing dalteparin based on actual body weight for the treatment of acute venous thromboembolism in obese patients","volume":"3","author":"Wells","year":"2005","journal-title":"J. Thromb. Haemost."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1055\/s-0037-1613090","article-title":"Dosing in heavy-weight\/obese patients with the LMWH, tinzaparin: A pharmacodynamic study","volume":"87","author":"Hainer","year":"2002","journal-title":"Thromb. Haemost."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1111\/jth.13323","article-title":"Use of the direct oral anticoagulants in obese patients: Guidance from the SSC of the ISTH","volume":"14","author":"Martin","year":"2016","journal-title":"J. Thromb. Haemost."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/11\/1707\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T04:12:35Z","timestamp":1780287155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/11\/1707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":78,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["cancers18111707"],"URL":"https:\/\/doi.org\/10.3390\/cancers18111707","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]}}}