the need for a vena cava filter in oncological patients with acute venous thrombosis a marker of a worse prognosis background active cancer is found in approximately 20 of patients diagnosed with venous thromboembolism this condition is more prevalent in patients with advanced and metastatic cancer and is the second largest cause of death among patients with active neoplasm many of them have contraindication for anticoagulation and needs an inferior vena cava filter to be implanted but a large proportion of these patients have very low survival after filter implantation our aim was to verify whether the need for filter implantation represents an independent indicator of poor prognosis in oncological patients and to identify subgroups with a greater survivalmethods this study included a retrospective analysis of 247 oncologic patients with acute proximal venous thrombosis we compared survival between 100 consecutive patients who needed vena cava filter filter group versus a control group of 147 patients in whom anticoagulation was possible anticoagulation group we verified survival cause of death filters indications clinical and surgical and factors that might lead to worse prognosisresults risk of death was 883fold higher in the filter group than that in the anticoagulation group a greater risk than the presence of metastasis or 247 death was significantly more frequent in patients subjected to filter implantation because of clinical indications 932 such as high risk of or recent bleeding and an adjusted risk of death of 224fold higher in a multivariate analysisconclusions the need to implant a vena cava filter in a patient with cancer is a marker that indicates patients disease severity and worse prognosis survival was longer in the subgroup of patients who underwent filter implantation before oncologic surgery probably because of a better status performance and less clinical complications