Avtor/Urednik		Kupnik, Dejan; Takač, Iztok
Naslov		Diagnostični in prognostični pomen venske trombembolije pri raku jajčnikov
Prevedeni naslov		Diagnostic and prognostic importance of venous thromboembolism in ovarian cancer
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 76, št. 3
Leto izdaje		2007
Obseg		str. 179-83
Jezik		slo
Abstrakt		Cancer and its chemotherapy are well known risk factors for venous thromboemholism. The later can be the first sign of arc occult malignancy, especially if it is recurrent one. Venous thromboembolism is also a common cause of morbidity and mortality among cancerpatients. In time of the first presentation of venous thromboemholism in the context of underlying cancer the advanced stage of cancer is usually present and this is as sociated with poor prognosis. Ovarian cancer which is diagnosed within, f our months after an episode of venous thromboembolism is usually in advanced stages with more aggressive biological properties. Low-molecular-weight-heparins are the cornerstone of treatment and prophylaxis of venous thromboembolism associated with cancer for the first 3 to 6 months after acute venous thromboembolic event. In accordance with current consensus they are replaced with oral anticoagulants after 6 months of treatment. According to recent trials lowmolecular-weight-heparins cause less side effects and there are less recurrent venous throm boembolisms than with peroral anticoagulant therapy. Accordingly their impact on improved survival of cancer patients is under intensive research. Unfortunately, there is currently no screening test for ovarian cancer which would lead to improved survival.
Izvleček		Rak in zdravljenje raka sta znana dejavnika tveganja za vensko trombembolijo. Slednja je lahko prvi znak še neodkrite maligne bolezni, še posebej, če se ponavlja. Je pomemben vzrok obolevnosti in smrtnosti bolnikov z rakom. Ob prvi epizodi venske trombembolije, če je v sklopu raka, je rak najpogosteje že v napredovali fazi in ima slabo napoved izida. Tudi kadar se diagnoza raka jajčnikov postavi znotraj štirih mesecev po venski trombemboliji, je to povezano z bolj napredovalo boleznijo in agresivnejšim tipom raka. Pri začetnem in nadaljnjem 3- do 6 mesečnem antikoagulacijskem zdravljenju po venski trombemboliji v sklopu raka se uporabljajo nizkomolekularni heparini, ki jih po šestih mesecih po sedanjem dogovoru zamenjajo peroralna antikoagulacijska zdravila. Dosedanje raziskave, na podlagi katerih pa še ni mogoče napraviti zaključkov, kažejo, da je zdravljenje z nizkomolekularnimi heparini povezano z manj stranskimi učinki in z manj ponovnimi venskimi trombembolijami kot peroralno antikoagulacijsko zdravljenje. Vsaj v populaciji bolnikov z boljšo napovedjo izida verjetno tudi izboljša preživetje zaradi vpliva na biološko obnašanje tumorja, ker zmanjša njegovo agresivnost Ustreznega presejalnega testa za ženske, s katerim pa bi odkrili raka jajčnikov in s tem tudi izboljšali napoved izida za sedaj žal še ni.
Deskriptorji		OVARIAN NEOPLASMS THROMBOEMBOLISM ANTICOAGULANTS HEPARIN, LOW-MOLECULAR-WEIGHT SURVIVAL ANALYSIS