A study on thromboembolism of patients with pancreatic cancer.

Abstract

262 Background: There have been studies on the association between thromboembolism (TE) and pancreatic cancer in Caucasian patients. This study aims to study the TE in Chinese patients with pancreatic cancer. Methods: This study retrospectively reviewed consecutive patients with confirmed diagnoses of pancreatic cancers from 2010-2015 in the Prince of Wales Hospital in Hong Kong. Patients with radiologically confirmed TE were identified. Corresponding information related to the type and site of TE were recorded. Predictive factors for the TE were studied by multivariate analysis. Results: Total 372 patients with pancreatic cancer were identified. In the cohort, the diagnoses of cancers were made by histology in 225 (60.5%) of them while others were made by radiology. The stage was as follows: 15 (4.1%) stage I; 113 (30.4%) stage II; 47 (12.7%) stage III and 196 (52.7%) stage IV. Total 55 (14.7%) patients had TE after diagnosis of pancreatic cancer. Of these 55 patients, 33 (60%) and 18 (32.7%) had venous and arterial events, respectively. For patients with TE, 27 (49.1%) were treated with anti-coagulants, and 13 (23.6%) had surgery within 2 years. The median time from surgery to the development of TE was 1.06 years. Patients with ECOG ≥2 and metastatic disease (HR 2.92, 95% CI 1.58-5.37; HR 6.90, 95% CI 3.63-13.14 respectively) had a higher risk of developing TE. Patients with venous, arterial, or both types of TE did not have significantly different overall survival. Poor prognostic factors for overall survival include ECOG ≥2 (HR 2.80, 95% CI 2.18-3.60) and tumour stage (stage II disease HR 1.36, 95% CI 0.70-2.62; stage III disease HR 1.85, 95% CI 0.92-3.70; stage IV disease HR 4.92, 95% CI 2.58-9.36). The presence of TE equated to a worse overall survival (median overall survival 148 vs. 228 days, HR 1.03, 95% CI 0.75-1.40, P=0.87), which was statistically insignificant. Conclusions: TE was similarly high in Chinese patients with pancreatic cancer. Patients with poorer performance status and metastatic disease had a greater risk of developing TE. Patients with TE had a worse overall survival (which was statistically insignificant) compared to patients without TE.