Efficacy and safety of inferior vena cava filters in patients with gynaecological cancers: a systematic review

Abstract Background: Venous thromboembolism (VTE) is a significant perioperative risk in gynaecological cancers. While anticoagulation is standard prophylaxis, some patients require inferior vena cava (IVC) filters due to contraindications. However, evidence on their efficacy and impact remains limited and conflicting. Objectives: This systematic review analyses existing literature on IVC filter use in gynaecological oncology. Search Strategy: A systematic search of CINAHL, Medline, Embase, and Cochrane databases was conducted using the keywords (’IVC filter’) AND (’Gynaecological cancer’). Selection criteria: Studies published between January 2003 and December 2024 involving human subjects with gynaecological cancer and IVC filter use were included, while reviews, case reports, non-gynaecological cancers, alternative treatments were excluded. Data Collection and Analysis: A narrative systematic review was conducted, grouping results by indication, filter type, timing, complications, and survival outcomes. Main Results: Eight retrospective studies met inclusion criteria, encompassing 287 patients, primarily with advanced ovarian cancer (62%). Indications for filter placement varied, including current deep vein thrombosis (DVT) requiring surgery and anticoagulation contraindications. Combined filter use with anticoagulation reduced VTE events in most studies. Filter-related complications (e.g., migration, thrombosis, tilt, fracture) were infrequent (0–2%). No consistent association between IVC filter use and survival outcomes was observed, highlighting the need for further prospective research. Conclusions: : IVC filters benefit patients with anticoagulation contraindications, failures, or urgent surgical needs. However, due to potential complications, prophylactic use is not recommended, and prompt retrieval is advised when safe. Funding: No funding was needed for this review. Key Words: IVC filter, Venous thrombo-embolism, Gynaecological cancer