Early venous thromboembolism is a strong prognostic factor in patients with advanced pancreatic ductal adenocarcinoma.

Abstract

BACKGROUND:

There are still controversial data regarding the prognostic value of Venous ThromboEmbolism (VTE) in advanced Pancreatic Ductal AdenoCarcinoma (PDAC) and thromboprophylaxis is poorly prescribed despite international recommendations.

METHODS:

Medical charts of patients consecutively treated for advanced PDAC from 2010 to 2019 were retrospectively reviewed. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method. Prognostic Factors were identified using a multivariate Cox's proportional hazard model. Early VTE was defined as VTE occurring within the three months following the PDAC diagnosis.

RESULTS:

A total of 174 patients were included (median age: 67 years; males: 55.2%; performance status (PS) 0-1: 88.5%) with metastatic disease in 74.7%. At baseline, Khorana score was high (≥ 3) in the vast majority of cases (93.7%). The cumulative incidences of VTE were 12.4% (95% CI 7.3-17.2) at 3 months, 20.4% (95% CI 13.9-26.4) at 6 months and 28.1% (95% CI 20.0-35.3) at 12 months. Patients who experienced early VTE had shorter PFS (3.8 months vs. 7.1 months; HR = 2.02; 95% CI 1.21-3.37; p = 0.006) and shorter OS (8.0 months vs. 14.1 months; HR = 2.42; 95% CI 1.37-4.30; p = 0.002) compared to the others, independently of prognostic factors such as PS, liver metastases, carcinomatosis, and chemotherapy regimen.

CONCLUSION:

early VTE is a strong prognostic factor in advanced PDAC and occurs in about one in 10 patients.

• Authors: Mathilde Barrau, Khawla Maoui, Bertrand Le Roy, Xavier Roblin, Patrick Mismetti, Jean-Marc Phelip, Nicolas Williet
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 147 Issue 11 Pg. 3447-3454 (Nov 2021) ISSN: 1432-1335 [Electronic] Germany
• PMID: 33715087 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Topics

• Aged
• Carcinoma, Pancreatic Ductal (epidemiology, pathology)
• Cohort Studies
• Female
• France (epidemiology)
• Humans
• Incidence
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Pancreatic Neoplasms (epidemiology, pathology)
• Prognosis
• Progression-Free Survival
• Proportional Hazards Models
• Retrospective Studies
• Survival Rate
• Venous Thromboembolism (epidemiology, pathology)