Venous Thromboembolism Risk Persists Post-Cancer Surgery Despite Guidelines

Data from the Medical University of South Carolina show that despite guidelines recommending extended pharmacologic prophylaxis for 30 days after surgery, the adoption of this practice remains low among patients undergoing major cancer surgery. A single-center retrospective cohort study analyzed data from 5246 patients and found that only 17.1% received extended prophylaxis, with significant variations based on demographic and procedural factors.

Key Takeaways:

• Extended pharmacologic prophylaxis is recommended for 30 days after major cancer surgery to prevent venous thromboembolism (VTE), but adoption remains low at 17.1%.
• Utilization of extended prophylaxis varies by specialty, with higher rates observed in females, Medicare or Medicaid insurance holders, and increasing age.
• Patients with below poverty level income, Black patients, and those undergoing minimally invasive surgery have lower odds of receiving extended prophylaxis.
• Multivariable regression analysis showed that patients with below poverty level income and Black patients had lower adjusted odds ratios of receiving extended prophylaxis.
• The research concludes that differences in use based on income and race suggest potentially modifiable factors related to social and structural determinants of health.
• Jingwen Zhang, Alexander Booth, Justin E. Marsden, Colleen Donahue, and Thomas Curran conducted the study, which was financially supported by the American Cancer Society.

Statistics:

• Only 17.1% of 5246 patients received extended pharmacologic prophylaxis after major cancer surgery.
• Extended prophylaxis use varied by specialty, with rates ranging from 14.3% (below poverty level) to 23.9% (non-minimally invasive surgery).
• Multivariable regression analysis showed lower adjusted odds ratios of receiving extended prophylaxis for patients with below poverty level income (0.73, CI: 0.60-0.88) and Black patients (0.72, CI: 0.58-0.89).
• The study was conducted between 2014 and 2021.

Sources:

• Zhang, J., et al. "Guideline-Concordant Provision of Extended Prophylaxis for Venous Thromboembolism After Major Cancer Surgery Differs by Social and Structural Determinants of Health." The American Surgeon[TM] 2025: 31348251385110.
• Reports on Venous Thromboembolism Findings from Medical University of South Carolina Provide New Insights (Guideline-Concordant Provision of Extended Prophylaxis for Venous Thromboembolism After Major Cancer Surgery Differs by Social and ...). Clinical Trials Week. October 20, 2025; p 760.