title: Impact of venous thromboembolism on the natural history of pancreatic adenocarcinoma.
abstract: BACKGROUND
  Few studies have analyzed the effect of venous thromboembolism (VTE) events on the prognosis of pancreatic cancer, but their results were conflicting. The present study was undertaken to determine the effect of VTE on pancreatic adenocarcinoma (PA) outcomes.
  
  
  METHODS
  All consecutive patients diagnosed with PA from May 2004 to January 2012 in a single oncology center were retrospectively studied. Clinical, radiological and histological data at time of diagnosis or within the first 3 months after surgery, including the presence (+) or absence (-) of VTE were collected. VTE was defined as radiological evidence of either pulmonary embolism (PE), deep venous thrombosis without infection or catheter-related thrombosis. PA with and without PE was compared for survival using the Kaplan-Meier method to estimate overall survival.
  
  
  RESULTS
  Among 162 PA patients with a median follow-up of 15 (3-92) months after diagnosis, 28 demonstrated VTE (+). PA patients with and without PE were similar for age, American Society of Anesthesiologist score, body mass index, and history of treatment. The distribution of cancer stages was similar between the two groups VTE (+) and VTE (-). The median duration of survival was significantly worse in the VTE (+) group vs VTE (-) (12 vs 18 months, P=0.010). In multivariate analysis, the presence of VTE and surgical treatment were independent prognostic factors for overall survival.
  
  
  CONCLUSIONS
  VTE (+) at time of diagnosis or within the first 3 months after surgery during treatment is an independent factor of poor prognosis in PA.
authors.affiliation: Departments of Digestive Surgery, Timone Hospital, Aix-Marseille University, Marseille, France; Atelier Provencale d'Ecriture Medicale, Faculte de Medecine de Marseille; Groupe Francophone Thrombose et Cancer, Hopital ST Louis, 1 avenue Claude Vellefaux, Paris, France. mehdi.ouaissi@ mail.ap-hm.fr.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ouaissi
authors.forename: Cecilia
authors.initials: C
authors.lastname: Frasconi
authors.forename: Diane
authors.initials: D
authors.lastname: Mege
authors.forename: Laurence
authors.initials: L
authors.lastname: Panicot-Dubois
authors.forename: Laurence
authors.initials: L
authors.lastname: Boiron
authors.forename: Laetitia
authors.initials: L
authors.lastname: Dahan
authors.forename: Philippe
authors.initials: P
authors.lastname: Debourdeau
authors.forename: Christophe
authors.initials: C
authors.lastname: Dubois
authors.forename: Dominique
authors.initials: D
authors.lastname: Farge
authors.forename: Igor
authors.initials: I
authors.lastname: Sielezneff
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality