Abstract
BackgroundThis study investigated the prognostic effects of venous thromboembolism (VTE)-related factors in patients with metastatic pancreatic cancer receiving palliative chemotherapy. Predictive factors for VTE were also investigated.MethodsA total of 216 patients diagnosed with metastatic pancreatic cancer who received gemcitabine-based palliative chemotherapy at our institution were retrospectively evaluated.ResultsVTE occurred in 51 (23.6%) patients during treatment and did not affect survival. However, patients who were diagnosed with VTE at the beginning of chemotherapy showed poor prognosis compared with patients diagnosed with VTE during chemotherapy: all patients (hazard ratio [HR] 1.897, p = 0.008); patients diagnosed with VTE (HR = 3.768, p = 0.001). Low serum sodium (Na) (< 135 mmol/L) and high Khorana score (≥3) were strong predictive factors of early VTE (odds ratio [OR] 5.109; 95% confidence interval [95% CI] = 1.010–25.845; p = 0.049 for Khorana score, OR 10.304; 95% CI = 1.036–102.466; p = 0.047) for hyponatremia).ConclusionsOur study demonstrated that occurrence and detection of VTE in the early period of chemotherapy was the most significant VTE-related prognostic factor in patients with metastatic pancreatic cancer receiving chemotherapy. Prediction using the Khorana score and serum Na levels would be helpful in early diagnosis of VTE.
Highlights
This study investigated the prognostic effects of venous thromboembolism (VTE)-related factors in patients with metastatic pancreatic cancer receiving palliative chemotherapy
All patients received gemcitabine alone or gemcitabine-based combination chemotherapy as the first-line treatment: gemcitabine only (8.3%), gemcitabine + erlotinib (35.2%), gemcitabine + fluorouracil, gemcitabine + platinum, gemcitabine + nab-paclitaxel (0.5%), gemcitabine +/− clinical trial agents included in phase III studies (8.3%)
The prognostic factors among patients diagnosed with VTE were investigated because these factors might be helpful to predict survival and to determine active treatment in this patient group
Summary
This study investigated the prognostic effects of venous thromboembolism (VTE)-related factors in patients with metastatic pancreatic cancer receiving palliative chemotherapy. Pancreatic cancer is a highly lethal malignancy and a major cause of cancer-related death. The incidence of pancreatic cancer continues to increase worldwide, but improvements in patient survival have been dismal. The median overall survival (OS) of patients with unresectable metastatic pancreatic cancer without treatment is Cancer is a well-known risk factor for venous thromboembolism (VTE). The risk of VTE is 4- to 7-fold higher in patients with cancer compared to patients without cancer [3]. Pancreatic cancer is associated with the highest risk of VTE occurrence [4]. Chemotherapy further increases the risk of VTE [5].
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