Role of vena cava filters for the management of cancer-related venous thromboembolism: Systematic review and meta-analysis

Background: Results from cohort studies evaluating the benefit in prevention of recurrent Venous Thromboembolism in cancer population are heterogeneous and controversial. Objective: To determine the effectiveness and harms of vena cava filters alone or combined with anticoagulation to prevent the risk of recurrent venous thromboembolism in patients with cancer-related venous thromboembolism. Materials and Methods: A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. Clinical trials were included without language restrictions. The risk of bias was evaluated with the Cochrane Collaboration's tool and a modified version for cohort studies. An analysis of fixed effects was conducted. The primary outcome was recurrent venous thromboembolism. The secondary outcomes were overall survival and adverse effects. The measure of the effect was the risk ratio with a 95% confidence interval. Results: Seven studies were included in the qualitative and quantitative analysis. 35,333 patients were found among the seven studies. A low risk of bias was shown for most of the study items. The overall risk ratio (RR) for recurrent venous thromboembolism was 2.53 95%CI (1.35–4.75) favoring anticoagulation compared with vena cava filter. Conclusion: Vena cava filter did not show benefits for recurrent venous thromboembolism prevention in the cancer-patients population.