The effects of unfractionated heparin on survival in patients with malignancy - A systematic review

Clinical and experimental studies have suggested that unfractionated hepari n (UFH) effects malignancy progression. We reviewed all published clinical reports concerning the effects of UFH, as compared to no treatment on survi val of cancer patients. Studies were classified on methodological strength and subdivided as to whether therapeutic or prophylactic dosages of UFH wer e used. Mortality rates after 3 years were extracted or calculated. One ran domized study that evaluated the use of UFH in therapeutic dosages in patie nts with small cell lung carcinoma reported on an improved survival (odds r atio (OR) 0.64; 95% confidence interval (CI): 0.25 to 1.62), A detrimental effect was observed in 2 randomized studies which investigated the effects of intraportal UFH treatment in a prophylactic dose after surgery for gastr ointestinal cancer (OR 1.66; 95% CI: 1.02 to 2.71). In contrast, level 2 st udies in which either therapeutic or prophylactic dosages of UFH on mortali ty of patients with gastrointestinal cancer were evaluated, showed OR of 0. 58 (95% CI; 0.11-3.13) and 0.65 (95% CI 0.51 to 0.84), respectively. We con clude that there is no convincing evidence of either positively or negative ly effects of UFH on survival of patients with malignancy.