Risk of venous thrombosis in patients with pancreatic adenocarcinoma.
OBJECTIVE
To estimate the risk of venous thrombosis associated with pancreatic adenocarcinoma and its consequences on treatment and survival.


METHODS
We retrospectively analyzed a cohort of 90 patients (49 males, 41 females - median age: 67 years [range: 37-94]). Pancreatic adenocarcinoma was histologically proved in 72 patients (81%) and was metastatic in 49 patients (54.4%). A venous thrombosis was observed in 24 patients (26.7%). A pulmonary embolism occurred in 4 patients with 2 deaths. The risk of venous thrombosis was significantly reduced by the use of anti-thrombotic prophylaxis (HR: 0.03 [95CI: 0.003-0.27]) and increased among patients with a biological inflammatory syndrome (HR: 9.0 [95CI: 2.30-34.4]) and metastatic disease (HR: 4.4 [95CI: 1.1-17.9]). Overall survival was not different between patients with (6.6 months) or without (6.1 months) venous thrombosis.


CONCLUSIONS
The risk of venous thrombosis is important and may delay the treatment in patients with advanced pancreatic carcinoma. Some patients with high risk of venous thrombosis may benefit from a prophylactic anticoagulant treatment.
Mitry
Emmanuel
E
Service d'hépatogastroentérologie et oncologie digestive; Hôpital Ambroise-Paré, APHP. Boulogne.
Taleb-Fayad
Raffic
R
Deschamps
Antoine
A
Mansencal
Nicolas
N
Lepère
Céline
C
Declety
Gilles
G
Lièvre
Astrid
A
Vaillant
Jean-Nicolas
JN
Lesur
Gilles
G
Cramer
Elisabeth
E
Dubourg
Olivier
O
Rougier
Philippe
P
D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D002408:Catheters, Indwelling; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications*; D011655:Pulmonary Embolism / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D020246:Venous Thrombosis / Q000209:etiology* / Q000517:prevention & control
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight