Venous Thromboembolism in Patients with Advanced Pancreatic Cancer Receiving Palliative Chemotherapy: Incidence and Effect on Prognosis

• Published in: The Korean journal of gastroenterology Vol. 81; no. 3; pp. 109 - 120
• Main Authors: Jeong, Han Taek, Bae, June Hwa, Kim, Ho Gak, Han, Jimin
• Format: Journal Article
• Language: English
• Published: Korea (South) Jin Publishing & Printing Co 25-03-2023
• Subjects: Adenocarcinoma - pathology; Humans; Incidence; pancreatic cancer; Pancreatic Neoplasms; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - drug therapy; Prognosis; Retrospective Studies; Risk Factors; survival analysis; thromboembolism; Venous Thromboembolism - complications; Venous Thromboembolism - etiology; Survival analysis; Thromboembolism; Pancreatic cancer; Risk factors; Incidence
• ISSN: 1598-9992; 2233-6869
• DOI: 10.4166/kjg.2022.137

This study evaluated the incidence of venous thromboembolism (VTE) in patients with advanced pancreatic ductal adenocarcinoma (PDAC) at the authors' institution and analyzed the risk factors associated with VTE and the overall survival (OS).
One hundred and seventy patients with locally advanced or metastatic PDAC who received palliative chemotherapy at Daegu Catholic University Medical Center from January 2011 to December 2020 were included.
During a median follow-up period of 341 days, 24 patients (14.1%) developed VTE. Cumulative incidence values of VTE were 4.7% (95% confidence interval [CI], 2.39-9.22) at 90 days, 9.9% (95% CI, 6.14-15.59) at 180 days, and 16.9% (95% CI, 11.50-24.36) at 360 days. Multivariate analysis showed that a carbohydrate antigen 19-9 (CA 19-9) level over 1,000 U/mL (hazard ratio [HR], 2.666; 95% CI, 1.112-6.389; p=0.028) and a history of alcohol consumption (HR, 0.327; 95% CI, 0.109-0.981; p=0.046) were significant factors associated with VTE. Patients with VTE showed a shorter median survival (347 days vs. 556 days; p=0.041) than those without VTE. Multivariate analysis revealed VTE (HR, 1.850; 95% CI, 1.049-3.263; p=0.033) and CA 19-9 level over 1,000 U/mL (HR, 1.843; 95% CI, 1.113-3.052; p=0.017) to be significant risk factors associated with OS.
The cumulative incidence of VTE in patients with advanced PDAC was 16.9% at 360 days. While a history of alcohol consumption was a protective factor, a high CA19-9 level was a risk factor for VTE. In addition, the occurrence of VTE was associated with poor prognosis.