Prophylactic anticoagulation in isolated tumor thrombus: a single-center retrospective cohort study.
5 affiliations
- 1Department of Interdisciplinary Patient Pathway, Gustave Roussy, Villejuif, France.
- 2Department of Anesthesiology, Gustave Roussy, Villejuif, France.
- 3Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
- 4Department of Hematology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, INSERM UMR-S-1166, Institut hospitalo-Universitaire ICAN, Paris, France.
- 5INNOVTE network, Saint-Étienne, France.
Abstract
Background
The optimal management of isolated tumor thrombus (TT) remains unknown. Although therapeutic anticoagulation is indicated for concurrent bland thrombosis or history of venous thromboembolism, current guidelines do not specifically address isolated TT, and recent studies have not shown consistent benefit of anticoagulation in this setting.Objectives
This study described the characteristics of patients with isolated TT managed at Gustave Roussy Comprehensive Cancer Center for over 5 years and explored outcomes, including overall survival, thrombotic events, and bleeding, across different anticoagulation strategies.Methods
This retrospective single-center cohort study included consecutive adults with imaging-confirmed isolated TT managed at Gustave Roussy from November, 2018 to June, 2024. Patients receiving therapeutic anticoagulation for any indication were excluded. The primary outcome was overall survival. Secondary outcomes were incident thromboembolic events and bleeding.Results
Among 1262 screened records, 29 patients with isolated TT met eligibility criteria (mean age 55.6 ± 15.7 years; 75.9% male; 93.1% had stage IV cancer). Ten received prophylactic-dose anticoagulation, and 19 received no anticoagulation. Restricted mean overall survival was 50.7 months (95% CI, 43.3-58.06) in the prophylactic anticoagulation group vs 20.8 months (95% CI, 10.8-30.9) in the no-anticoagulation group. New bland thrombosis and bleeding events were infrequent and did not differ significantly between groups.Conclusion
In this small retrospective cohort, longer survival was observed in patients receiving prophylactic-dose anticoagulation. This finding may reflect residual confounding and selection of patients with more favorable prognosis rather than a true therapeutic effect and should therefore be interpreted with considerable caution.
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BibTeX
@article{papageorgiou2026prophylactic,
title = {{Prophylactic anticoagulation in isolated tumor thrombus: a single-center retrospective cohort study.}},
author = {Loula Papageorgiou and Jamie Elmawieh and Paul Beunon and Fehmi El Karoui and Salim Idelcadi and Florian Scotté and Corinne Frère},
journal = {Research and practice in thrombosis and haemostasis},
year = {2026},
month = aug,
doi = {10.1016/j.rpth.2026.106951},
url = {https://europepmc.org/article/MED/42908642},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prophylactic anticoagulation in isolated tumor thrombus: a single-center retrospective cohort study.
AU - Loula Papageorgiou
AU - Jamie Elmawieh
AU - Paul Beunon
AU - Fehmi El Karoui
AU - Salim Idelcadi
AU - Florian Scotté
AU - Corinne Frère
PY - 2026
DA - 2026/08/01
JO - Research and practice in thrombosis and haemostasis
DO - 10.1016/j.rpth.2026.106951
UR - https://europepmc.org/article/MED/42908642
AB - Background The optimal management of isolated tumor thrombus (TT) remains unknown. Although therapeutic anticoagulation is indicated for concurrent bland thrombosis or history of venous thromboembolism, current guidelines do not specifically address isolated TT, and recent studies have not shown consistent benefit of anticoagulation in this setting.Objectives This study described the characteristics of patients with isolated TT managed at Gustave Roussy Comprehensive Cancer Center for over 5 years and explored outcomes, including overall survival, thrombotic events, and bleeding, across different anticoagulation strategies.Methods This retrospective single-center cohort study included consecutive adults with imaging-confirmed isolated TT managed at Gustave Roussy from November, 2018 to June, 2024. Patients receiving therapeutic anticoagulation for any indication were excluded. The primary outcome was overall survival. Secondary outcomes were incident thromboembolic events and bleeding.Results Among 1262 screened records, 29 patients with isolated TT met eligibility criteria (mean age 55.6 ± 15.7 years; 75.9% male; 93.1% had stage IV cancer). Ten received prophylactic-dose anticoagulation, and 19 received no anticoagulation. Restricted mean overall survival was 50.7 months (95% CI, 43.3-58.06) in the prophylactic anticoagulation group vs 20.8 months (95% CI, 10.8-30.9) in the no-anticoagulation group. New bland thrombosis and bleeding events were infrequent and did not differ significantly between groups.Conclusion In this small retrospective cohort, longer survival was observed in patients receiving prophylactic-dose anticoagulation. This finding may reflect residual confounding and selection of patients with more favorable prognosis rather than a true therapeutic effect and should therefore be interpreted with considerable caution.
SN - 2475-0379
ER -