Open AccessEfficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research
Author(s) -
Tamara Zec,
Raffaela Di Napoli,
Lydwine Fiévez,
Mohammed Ben Aziz,
Alessandro Ottaiano,
Alessandro Vittori,
Francesco Perri,
Marco Cascella
Publication year - 2022
Publication title -
journal of multidisciplinary healthcare
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.65
H-Index - 30
ISSN - 1178-2390
DOI - 10.2147/jmdh.s337250
Subject(s) - tranexamic acid , medicine , perioperative , antifibrinolytic , cancer , blood transfusion , intensive care medicine , surgery , blood loss
In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the link between perioperative transfusion and increased risk of cancer recurrence cannot be excluded. On the other hand, cancer patients have an increased risk of thromboembolism due to cancer itself and antineoplastic systemic treatments including chemotherapy and anti-angiogenic drugs. In this complex scenario, effective and safe strategies aimed at the prevention of blood transfusions are warranted. This narrative review addresses the efficacy, and the safety of the synthetic antifibrinolytic agent tranexamic acid (TXA) when used perioperatively in cancer surgery. Although in not oncologic surgery the use of TXA has been extensively studied, in the setting of cancer patients requiring surgery, the evidence is scarce. An overview of the ongoing clinical research is also provided.