Comparing enoxaparin and aspirin for preventing blood clots after pelvic or leg cancer surgery

You may qualify if

• Patients will first be evaluated for inclusion in a master observational study with the following inclusion criteria:; Age ≥18 years; Prior or planned surgery on the pelvis or lower extremity; Fulfills one of the following: a. Cohort A: Metastatic osseous disease, undergoing: i. Endoprosthetic reconstruction ii. Curettage, cement packing, and fixation with nails, plates, and/or screws iii. Intramedullary nail fixation only b. Cohort B: Primary bone sarcoma, undergoing wide resection, amputation, or reconstruction with endoprosthesis, allograft, or allograft-prosthesis composite (APC). c. Cohort C: Primary soft tissue sarcoma ≥5 cm in diameter, undergoing wide resection; Anticoagulation therapy was received or is planned. In addition to fulfilling all the inclusion criteria in Part 1 of this study, participants must also not meet any of the below exclusion criteria in order to be eligible for randomization to either aspirin or LMWH.

You can't join if

• Documented prior history of VTE.
• Preoperative use of therapeutic or prophylactic chemical anticoagulation at the time of surgery.
• Documented allergy/adverse reaction to either of the two study drugs.
• Presence of inferior vena cava (IVC) filter.
• Known, diagnosed hypercoagulable state (other than malignancy).
• Inability to receive chemical anticoagulation.
• Preoperative use of full-strength aspirin 325 mg daily; patients already taking aspirin 81 mg daily will not be excluded.
• Inability for the patient him/herself to give informed consent due to delirium, dementia, or any other reason.
• Pregnancy
• Fear of needles that prevents administration of LMWH.
• Inability to administer medications via needles.
• For patients with metastatic osseous disease, a Khorana score of ≥3. Pregnancy testing, via a urine or blood test, is a routine part of pre-operative laboratory testing in patients scheduled to undergo orthopaedic surgeries. Attending surgeons may also choose to exclude any patient from randomization at their discretion.