Incidence and risk factors for venous thromboembolism in the Cancer-VTE Registry pancreatic cancer subcohort

Abstract

Background This substudy of the Cancer-VTE Registry estimated venous thromboembolism (VTE) incidence and risk factors in pancreatic cancer patients. Methods The Cancer-VTE Registry was an observational study that collected VTE data from patients with solid tumors across Japan. We measured baseline VTE prevalence, and at 1-year follow-up, the cumulative incidence of symptomatic and composite VTE (symptomatic VTE and incidental VTE requiring treatment), bleeding, cerebral infarction/transient ischemic attack (TIA)/systemic embolic event (SEE), and all-cause death. Results Of 1006 pancreatic cancer patients, 86 (8.5%) had VTE at baseline, and seven (0.7%) had symptomatic VTE. Significant risk factors of baseline VTE were Eastern Cooperative Oncology Group performance status (ECOG PS) of 1, body mass index (BMI) ≥ 25 kg/m2, history of VTE, D-dimer > 1.2 µg/mL, and hemoglobin < 10 g/dL. At 1-year follow-up, the cumulative incidence of events was higher for pancreatic cancer vs other cancers. Pancreatic cancer patients with VTE vs those without VTE had significantly higher incidences of bleeding, cerebral infarction/TIA/SEE, and all-cause death. No significant risk factors for composite VTE were identified. Conclusions The cumulative incidence of composite VTE during cancer treatment was higher in pancreatic cancer than in other cancer types. Some risk factors for VTE prevalence at cancer diagnosis were identified. Although VTE prevalence at cancer diagnosis did not predict the subsequent 1-year incidence of composite VTE, it was a significant predictor of other events such as all-cause death in pancreatic cancer patients. Trial registration UMIN Clinical Trials Registry; UMIN000024942

Venous thromboembolism incidence and association with overall survival in pancreatic cancer: A Finnish nationwide cohort study

“… 4 A Japanese nationwide multicenter observational study reported a VTE incide of 8.5% among stage II–IV PC patients with planned cancer treatment. 6 In their data, VTE prevalence was lower in other cancer types: 6.9% in stomach cancer, 6.4% in colorectal cancer, 5.5% in gynecologic cancer, 5.1% in lung cancer, and 2.0% in breast cancer. Furthermore, 1‐year cumulative VTE incidence was 3.6% among PC patients compared to 1.6% among other cancers.…”

“… 2 , 3 , 4 In PC patients, both symptomatic and asymptomatic VTEs are common. 2 , 5 , 6 , 7 Patients undergoing chemotherapy for metastasized PC are at an even greater risk of VTE. 4 , 8 , 9 , 10 , 11 VTEs detected early following a PC diagnosis associate with a worse survival and are indicative of more aggressive tumor pathology.…”