High risk of venous thrombosis in patients with pancreatic cancer: a cohort study of 202 patients.
To estimate the risk of venous thrombosis associated with pancreatic malignancies we followed a cohort of patients with pancreatic cancer (n = 202). We calculated incidence rates of venous thrombosis and compared this with population rates using a Standardised Morbidity Ratio (SMR). The effects of location, histology and treatment were assessed by Cox-modelling. The incidence of venous thrombosis was 108.3/1000 patient-years (95% confidence interval (CI) 64.4-163.8), 58.6-fold increased (SMR 58.6, 95% CI 36.9-92.9). Patients with a tumour of the corpus/cauda had a 2-fold increased risk compared with those with a tumour of the caput. Patients treated with chemotherapy had a 4.8-fold increased risk (HR(adj) 4.8, 95% CI 1.1-20.8), whereas radiotherapy did not increase the risk. In a postoperative period of 30 d, patients had a 4.5-fold increased risk of venous thrombosis (HR(adj) 4.5, 95% CI 0.5-40.9). The risk was 1.9-fold increased in the presence of distant metastases (HR(adj) 1.9, 95% CI 0.7-5.1). Anti-thrombotic prophylaxis seems warranted in the first month after surgery, during and after treatment with chemotherapy, and when distant metastases have been diagnosed.
Blom
J W
JW
Department of Clinical Epidemiology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Osanto
S
S
Rosendaal
F R
FR
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000628:therapy; D011182:Postoperative Care; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000517:prevention & control
D000964:Antimetabolites, Antineoplastic; D005343:Fibrinolytic Agents; D005472:Fluorouracil