Correction: Efficacy and safety evaluation of thromboprophylaxis strategies for central venous catheter-related thrombosis in cancer patients: a bayesian network meta-analysis and bibliometric analysis

Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420251218825.With changes in human lifestyles and behavioral patterns, cancer has become one of the leading diseases threatening global public health. During chemotherapy, the strong irritant properties of antineoplastic agents may cause tissue and organ damage or result in drug extravasation. The use of central venous catheter (CVC) allows the safe administration of chemotherapeutic agents and effectively reduces the risk of local tissue injury and extravasation. To ensure the continuous delivery of chemotherapy, parenteral nutrition, or blood transfusion, patients with malignancies often require long-term CVC placement.Common types of CVC include peripherally inserted central catheter (PICC), tunneled central venous catheters, and totally implantable venous access ports (Ports). However, Catheter Related Thrombosis (CRT), as one of the common complications after central venous catheterization, has become an important factor affecting the continuity of treatment and clinical efficacy of cancer patients. Studies have shown that the average incidence of CVCrelated thrombosis in cancer patients is about 5%-20%, and there is a certain mortality (CLOTS Trials Collaboration, 2014;Zhang et al., 2018), which is one of the risk factors leading to the death of cancer patients (Farge et al., 2016). Thrombotic events can increase the risk of disability, prolong hospitalization, interrupt intravenous chemotherapy, and exacerbate disease burden, thereby shortening patient survival and imposing substantial economic costs. CRT may also lead to catheter dysfunction, increased susceptibility to infection, and treatment interruption. In rare cases, it can result in post-thrombotic syndrome, cause further venous damage, or trigger life-threatening complications such as pulmonary embolism (PE), ultimately endangering patient survival (Geerts et al., 2004;Langer and Bokemeyer, 2012).Prophylactic anticoagulation has been proposed as an effective strategy to reduce the incidence of CVC-related thrombosis by inhibiting the coagulation cascade and decreasing thrombus formation around the catheter (Khorana, 2013;Mosarla et al., 2019). However, current guidelines still have different recommendations on preventive anticoagulation for CVC-related thrombosis in cancer patients. The Chinese Guidelines for the Prevention and Treatment of Thrombotic Diseases (Chinese Thrombosis Guidelines Expert Committee, 2018) recommend venous thromboembolism risk assessment for patients with central venous catheter. For patients with moderate or high risk and without anticoagulation contraindications, it is recommended to use low-molecular-weight heparin (LMWH) or edoxaban for CRT prevention. The American Society of Clinical Oncology (ASCO) (Lyman et al., 2015) advises prophylactic-dose LMWH, unfractionated heparin, or rivaroxaban for patients with a Khorana score ≥3 or those with pancreatic, lung, or gastric cancer. In contrast, the European Society for Medical Oncology (ESMO) (Falanga et al., 2023) and the American Society of Hematology (ASH) (Lyman et al., 2021) do not recommend the use of drugs to prevent CRT. The above situation indicates that there is still a lack of sufficient research evidence to support the clinical application of prophylactic anticoagulants and reach a consensus in guidelines. Therefore, more evidence is needed to support whether CRT prevention is necessary and which prevention strategy is safer and more effective (to maintain the balance between the efficacy of thrombosis prevention and the risk of bleeding, and to increase the benefit of patients).In this context, systematically reviewing the research progress and evidence gaps in this field is of great value. Bibliometric analysis can systematically map the research landscape, evolutionary trends and research hotspots in the field of prophylaxis for central venous catheter-related thrombosis in cancer patients; it not only clarifies the characteristic shift of mainstream anticoagulant strategies from traditional agents (warfarin, LMWH) to direct oral anticoagulants (DOACs) in this field, but also identifies the current evidence gaps and controversial issues lacking comprehensive quantitative comparison of multiple interventions. This provides a clear theoretical basis and research direction for the subsequent conduct of network meta-analysis, rendering the selection of interventions, setting of outcome indicators and determination of research priorities in the network meta-analysis more targeted and evidence-based. Network meta-analysis, on the other hand, can integrate both direct and indirect comparison evidence, quantitatively evaluating the differences in efficacy and safety among various prophylactic anticoagulation strategies. Therefore, this study intends to use bibliometric methods to analyze the landscape and development trajectory of CVC-related thrombosis anticoagulation in cancer patients, and to apply Bayesian network meta-analysis to comprehensively evaluate the efficacy and safety of different anticoagulants in preventing CRT. The aim is to provide evidence-based support for prophylactic anticoagulation decisionmaking, improve cancer patient prognosis, and offer future research directions in the field of CVC-related thrombosis anticoagulation.The current study follows the PRISMA statement (Page et al., 2021) (Supplementary Table S1), The complete study protocol was pre-registered at PROSPERO with the registration number CRD420251218825. As no personal patient information is involved, ethical approval is not required for this study.The Web of Science Core Collection database was searched, with the citation index set to Science Citation Index Expanded (SCI-Expanded), to construct the search strategy for CVC-related thrombosis prevention and treatment in cancer patients. All relevant literature from 2000 to 16 April 2025, was retrieved, limited to "Article" and "Review article" types, and restricted to English language. The search strategy is detailed in Supplementary Table S2.Search the PubMed, The Cochrane Library, Embase and Web of Science databases. The search time range extended from database inception to 28 May 2025. The search focused on clinical studies regarding prophylactic anticoagulation for CVC-related thrombosis in cancer patients, with no language restrictions. The search included keywords such as "anticoagulation," "central venous catheter", and "cancer." Additional keywords were derived by reviewing relevant literature appendices, and a combined approach of subject terms and free terms was used to construct the search strategy. The detailed search strategy is provided in Supplementary Table S3.The bibliometric analysis was conducted using the Web of Science (WoS) Core Collection, a widely regarded and standardized source for bibliometric data. WoS provides consistent metadata, such as citation counts, author affiliations, and indexed keywords, essential for constructing co-authorship networks, co-citation maps, and keyword co-occurrence analyses. These features make WoS an ideal choice for bibliometric mapping. Owing to the inherent functional limitations of bibliometric analysis software, which only support single-database operations, the bibliometric component of this study exclusively included the WoS Core Collection.The inclusion criteria for this study were as follows: (1) study population: Patients with malignancies who have undergone CVC (Central Venous Catheter) placement, aged ≥18 years, and received prophylactic anticoagulation during CVC placement. The tumor types include both hematologic and solid tumors; (2) interventions: All prophylactic anticoagulants were included in the search. The DOACs mainly included rivaroxaban, apixaban, edoxaban, and dabigatran; low molecular weight heparins (LMWH) included enoxaparin, dalteparin, nadroparin, etc.; vitamin K antagonists (VKAs) included warfarin and other coumarin and indanedione derivatives; (3) outcomes: The primary outcomes were venous thromboembolism (VTE) and major bleeding events. The secondary outcomes included all bleeding events, all-cause mortality events, and adverse events. VTE was defined as a composite of pulmonary embolism (PE) and deep venous thrombosis (DVT), including both symptomatic and asymptomatic cases. The occurrence of CRT must be confirmed through diagnostic methods. PE diagnosis included computed tomography (CT), D-dimer, CT pulmonary angiography, and ventilation/perfusion scanning. Diagnosis of symptomatic or asymptomatic DVT included color Doppler ultrasound, venography, D-dimer, CT venography, magnetic resonance venography, radioactive iodine fibrinogen uptake test, and impedance plethysmography. Major bleeding events, bleeding events, and adverse events were defined according to the standards of each study (bleeding events encompass all bleeding conditions, including major bleeding; adverse events included any non-bleeding adverse events). Death was defined as all-cause mortality, including both catheter-related thrombosis-related death and death due to cancer progression; (4) study types: randomized controlled trials (RCTs) or non-randomized controlled trials (Non-RCTs). 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