Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic carcinoma and treated with chemotherapy on an outpatient basis

Adrián, Silvia García; Rodríguez-González, Adan; Castro, Eva Martínez de; Olmos, Vanessa Pachón; Morán, L. Ortega; Prado, Purificación Martínez del; Fernández, Mercedes Salgado; Buron, Jose David Cumplido; Escobar, Ignacio; Martínez-Galán, Joaquina; Perez, A.; Neria, Fernando; Lavin, Diego Cacho; Hernández, Borja López de San Vicente; Jiménez-Fonseca, Paula; Martín, Andrés J. Muñoz

doi:10.1016/j.ejim.2022.07.020

Cited by 10 publications

(5 citation statements)

References 45 publications

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“…No active screening for VTE was made since this measure is not included in the clinical routine procedures at IPOP. As such, there was no accountability for clinically asymptomatic events, which represent the majority of cancer-related VTE events and are also considered to negatively impact a patient’s prognosis, although to a lesser extent 32 , 33 . Data concerning demographic and clinicopathological factors, as well as the follow-up of the patients, were also obtained from their medical files.…”

Section: Methodsmentioning

confidence: 99%

Thrombogenesis-associated genetic determinants as predictors of thromboembolism and prognosis in cervical cancer

Neto

Tavares

Silva

et al. 2023

Sci Rep

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Venous thromboembolism (VTE) is a leading cause of death among cancer patients. Khorana score (KS) is the most studied tool to predict cancer-related VTE, however, it exerts poor sensitivity. Several single-nucleotide polymorphisms (SNPs) have been associated with VTE risk in the general population, but whether they are predictors of cancer-related VTE is a matter of discussion. Compared to other solid tumours, little is known about VTE in the setting of cervical cancer (CC) and whether thrombogenesis-related polymorphisms could be valuable biomarkers in patients with this neoplasia. This study aims to analyse the effect of VTE occurrence on the prognosis of CC patients, explore the predictive capability of KS and the impact of thrombogenesis-related polymorphisms on CC-related VTE incidence and patients’ prognosis regardless of VTE. A profile of eight SNPs was evaluated. A retrospective hospital-based cohort study was conducted with 400 CC patients under chemoradiotherapy. SNP genotyping was carried on by using TaqMan® Allelic Discrimination methodology. Time to VTE occurrence and overall survival were the two measures of clinical outcome evaluated. The results indicated that VTE occurrence (8.5%) had a significant impact on the patient’s survival (log-rank test, P < 0.001). KS showed poor performance (KS ≥ 3, χ2, P = 0.191). PROCR rs10747514 and RGS7 rs2502448 were significantly associated with the risk of CC-related VTE development (P = 0.021 and P = 0.006, respectively) and represented valuable prognostic biomarkers regardless of VTE (P = 0.004 and P = 0.010, respectively). Thus, thrombogenesis-related genetic polymorphisms may constitute valuable biomarkers among CC patients allowing a more personalized clinical intervention.

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Section: Methodsmentioning

confidence: 99%

Thrombogenesis-associated genetic determinants as predictors of thromboembolism and prognosis in cervical cancer

Neto

Tavares

Silva

et al. 2023

Sci Rep

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“…26 particularly in early VTE, which was defined as within 1.5 months after the initiation of chemotherapy or within 3 months after diagnosis of PDAC. 7,9,13,16 Other studies reported that the occurrence of VTE does not significantly affect the prognosis. 5,8,11,14 As mentioned above, this is probably explained by the difference in the study population among studies.…”

Section: Risk Factors Associated With Overall Survivalmentioning

confidence: 98%

“…22 The location of the primary tumor is also a well-known risk factor for VTE, which has been commonly identified in several previous studies. 7,8,14,19 Most reported that body or tail cancer had a higher risk of VTE than head cancer. 7,8,19 On the other hand, in this study, the tumor location was not a statistically significant factor, even though pancreatic body cancer had a marginally protective effect according to multivariate analysis.…”

Section: Risk Factors Associated With Overall Survivalmentioning

confidence: 99%

“…Regarding symptoms, the proportion of incidental VTE was 50% in this study, similar to the 52.4% to 72% reported elsewhere. 7,8,10,12,14,19 In contrast, there have been conflicting results as to whether symptomatic VTE has a poorer progress than incidental VTE. 7,10,14,19 The data showed no significant difference with respect to OS according to the presence or absence of symptoms.…”

Section: Risk Factors Associated With Overall Survivalmentioning

confidence: 99%

“…4 The incidence ranged from 18% to 41.3% in retrospective Western cohorts. 5,[7][8][9][10] On the other hand, several studies reported that it was low in Asians (5.3-18%).…”

Section: Introductionmentioning

confidence: 99%

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Venous Thromboembolism in Patients with Advanced Pancreatic Cancer Receiving Palliative Chemotherapy: Incidence and Effect on Prognosis

Jeong

Bae

Kim

et al. 2023

Korean J Gastroenterol

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Background/Aims: This study evaluated the incidence of venous thromboembolism (VTE) in patients with advanced pancreatic ductal adenocarcinoma (PDAC) at the authors' institution and analyzed the risk factors associated with VTE and the overall survival (OS). Methods: One hundred and seventy patients with locally advanced or metastatic PDAC who received palliative chemotherapy at Daegu Catholic University Medical Center from January 2011 to December 2020 were included. Results: During a median follow-up period of 341 days, 24 patients (14.1%) developed VTE. Cumulative incidence values of VTE were 4.7% (95% confidence interval [CI], 2.39-9.22) at 90 days, 9.9% (95% CI, 6.14-15.59) at 180 days, and 16.9% (95% CI, 11.50-24.36) at 360 days. Multivariate analysis showed that a carbohydrate antigen 19-9 (CA 19-9) level over 1,000 U/mL (hazard ratio [HR], 2.666; 95% CI, 1.112-6.389; p=0.028) and a history of alcohol consumption (HR, 0.327; 95% CI, 0.109-0.981; p=0.046) were significant factors associated with VTE. Patients with VTE showed a shorter median survival (347 days vs. 556 days; p=0.041) than those without VTE. Multivariate analysis revealed VTE (HR, 1.850; 95% CI, 1.049-3.263; p=0.033) and CA 19-9 level over 1,000 U/mL (HR, 1.843; 95% CI, 1.113-3.052; p=0.017) to be significant risk factors associated with OS. Conclusions: The cumulative incidence of VTE in patients with advanced PDAC was 16.9% at 360 days. While a history of alcohol consumption was a protective factor, a high CA19-9 level was a risk factor for VTE. In addition, the occurrence of VTE was associated with poor prognosis.

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Update on the management of older patients with pancreatic adenocarcinoma: a perspective from medical oncology

Guillot Morales,

Visa,

Brozos Vázquez

et al. 2024

Clin Transl Oncol

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In the context of pancreatic cancer, surgical intervention is typically recommended for localized tumours, whereas chemotherapy is the preferred approach in the advanced and/or metastatic setting. However, pancreatic cancer is closely linked to ageing, with an average diagnosis at 72 years. Paradoxically, despite its increased occurrence among older individuals, this population is often underrepresented in clinical studies, complicating the decision-making process. Age alone should not determine the therapeutic strategy but, given the high comorbidity and mortality of this disease, a comprehensive geriatric assessment (CGA) is necessary to define the best treatment, prevent toxicity, and optimize older patient care. In this review, a group of experts from the Oncogeriatrics Section of the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica, SEOM), the Spanish Cooperative Group for the Treatment of Digestive Tumours (Grupo Español de Tratamiento de los Tumores Digestivos, TTD), and the Multidisciplinary Spanish Group of Digestive Cancer (Grupo Español Multidisciplinar en Cáncer Digestivo, GEMCAD) have assessed the available scientific evidence and propose a series of recommendations on the management and treatment of the older population with pancreatic cancer.

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Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic carcinoma and treated with chemotherapy on an outpatient basis

Cited by 10 publications

References 45 publications

Thrombogenesis-associated genetic determinants as predictors of thromboembolism and prognosis in cervical cancer

Thrombogenesis-associated genetic determinants as predictors of thromboembolism and prognosis in cervical cancer

Venous Thromboembolism in Patients with Advanced Pancreatic Cancer Receiving Palliative Chemotherapy: Incidence and Effect on Prognosis

Update on the management of older patients with pancreatic adenocarcinoma: a perspective from medical oncology

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