Background: Pancreatic ductal adenocarcinoma (PDAC) is among the most common malignancies associated with venous thromboembolism (VTE). However, despite recommendations basing on Khorana score commonly known to predict the risk of VTE, thromboprophylaxis has not been prescribed routinely in clinical practice, especially in patients with advanced PDAC.Methods: Medical charts of patients consecutively treated for advanced PDAC from 2010 to 2019 without thromboprophylaxis were retrospectively reviewed. The cumulative incidence of VTE was estimated using Kaplan-Meier method. Factors associated with VTE were identified using a multivariate Cox's proportional hazard model with stepwise selection process. Similar analyses were performed for survivals. Early VTE was defined as VTE occurring within the third months from PDAC diagnosis.Results: A total of 155 patients were included (median age: 68 years; males: 56.1%; performance status 0-1: 85.8%) with metastatic (70.3%) or locally advanced disease (29.7%). At baseline, Khorana score was high (!3) for the vast majority of cases (94.3%). The cumulative incidences of VTE were 12.2% (95%
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