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- Title
Early venous thromboembolism is a strong prognostic factor in patients with advanced pancreatic ductal adenocarcinoma.
- Authors
Barrau, Mathilde; Maoui, Khawla; Le Roy, Bertrand; Roblin, Xavier; Mismetti, Patrick; Phelip, Jean-Marc; Williet, Nicolas
- 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.
- Subjects
PROGNOSIS; THROMBOEMBOLISM; OVERALL survival; ACTIVATED protein C resistance; PANCREATIC tumors; PROPORTIONAL hazards models; PROGRESSION-free survival
- Publication
Journal of Cancer Research & Clinical Oncology, 2021, Vol 147, Issue 11, p3447
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-021-03590-x