Abstract
Patients with pancreatic carcinoma are at an increased risk of venous thromboembolism (VTE), which is a major cause of morbidity and mortality in various types of cancer. The aim of this study was to determine the incidence and clinical significance of VTE in patients with pancreatic carcinoma, and to identify biomarkers for the detection of VTE in these patients. The eligibility criteria were chemo-naïve patients with primary pancreatic carcinoma, an Eastern Cooperative Oncology Group performance status of 0–2, and adequate organ function. All patients were screened for VTE using compression ultrasonography and dynamic computed tomography. The primary endpoint was the incidence of VTE, which we hypothesized would be between 10.0–20.0% for symptomatic and asymptomatic patients combined. Associations between clinical presentation and VTE were evaluated. VTE-associated markers were also investigated for their role in predicting prognosis. In total, 103 patients met the eligibility criteria. The overall cumulative incidence rate of VTE in patients with previously untreated pancreatic carcinoma was 16.5%. VTE occurrence was strongly associated with elevated serum D-dimer, fibrin degradation product, thrombin/antithrombin III complex, and prothrombin fragment 1 + 2 levels. The median overall survival time of VTE-positive and VTE-negative patients was 427 and 515 days, respectively. Approximately one-sixth of patients with advanced pancreatic carcinoma experienced VTE, although most were asymptomatic. Measurement of serum D-dimer, fibrin degradation product, thrombin/antithrombin III complex, and prothrombin fragment 1 + 2 levels may be useful for the early detection of VTE in patients with advanced pancreatic carcinoma.
Highlights
Pancreatic carcinoma is one of the most lethal cancers
As pancreatic carcinoma has a high propensity for both local invasion and distant metastasis, surgical treatment is precluded for most patients who present with an advanced stage of the disease
The novelty of this study was to assess the frequency of venous thromboembolism (VTE) detected by compression ultrasonography (CUS) and computed tomography (CT) angiography in patients with pancreatic carcinoma at the time of diagnosis
Summary
Pancreatic carcinoma is one of the most lethal cancers It represents the fourth leading cause of cancerrelated death in developed countries [1]. As pancreatic carcinoma has a high propensity for both local invasion and distant metastasis, surgical treatment is precluded for most patients who present with an advanced stage of the disease. Venous thromboembolism (VTE) significantly increases the mortality rate of cancer patients and reduces www.oncotarget.com their quality of life. The overall incidence of symptomatic VTE in ambulatory patients with multiple cancers is approximately 3.0%. Is VTE considered an independent negative prognostic factor [9, 10], but the ensuing reduction in quality of life can delay cancer treatment, lead to more frequent and prolonged hospitalization, and result in higher treatment costs
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