Portal hypertension caused by pancreatic cancer: Multidetector computed tomography diagnosis and multivariate analysis of variceal hemorrhage

Li, Guoping; Hu, Xiang; Zhang, Zhaolong; Xu, Rui; Sun, Chengjian; Xin, Yong-Ning; Xuan, Shi-Ying

doi:10.4103/jcrt.jcrt_500_20

Cited by 6 publications

(4 citation statements)

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“… 31 , 32 In patients with mPC, PVO may be either caused by tumor infiltration or thrombosis of the portal vein, resulting in portal hypertension and impaired liver function. 33 , 34 Within the present study, PVO acted as an independent risk factor for ascites. Therefore, early anticoagulation at diagnosis of portal vein thrombosis (PVT) may be considered to counteract ascites development even though data addressing the treatment of malignant PVT are limited.…”

Section: Discussionmentioning

confidence: 48%

Clinical risk factors for ascites in metastatic pancreatic cancer

Berger¹,

Alany²,

Puhr³

et al. 2023

ESMO Open

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Section: Discussionmentioning

confidence: 48%

Clinical risk factors for ascites in metastatic pancreatic cancer

Berger¹,

Alany²,

Puhr³

et al. 2023

ESMO Open

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“…Chemotherapy can cause adverse effects such as thrombocytopenia and mucositis, increasing the risk of bleeding [57,128]. Tumor progression can also lead to an increased bleeding risk, for example, via gastroduodenal tumor invasion or PDAC-related portal hypertension [129][130][131].…”

Section: Interruption Of Primary Thromboprophylaxis During Neoadjuvan...mentioning

confidence: 99%

Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care

Willems

Michiels

Lanting

et al. 2023

Cancers

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Recent studies have shown that patients with pancreatic ductal adenocarcinoma (PDAC) treated with neoadjuvant chemo(radio)therapy followed by surgery have an improved outcome compared to patients treated with upfront surgery. Hence, patients with PDAC are more and more frequently treated with chemotherapy in the neoadjuvant setting. PDAC patients are at a high risk of developing venous thromboembolism (VTE), which is associated with decreased survival rates. As patients with PDAC were historically offered immediate surgical resection, data on VTE incidence and associated preoperative risk factors are scarce. Current guidelines recommend primary prophylactic anticoagulation in selected groups of patients with advanced PDAC. However, recommendations for patients with (borderline) resectable PDAC treated with chemotherapy in the neoadjuvant setting are lacking. Nevertheless, the prevention of complications is crucial to maintain the best possible condition for surgery. This narrative review summarizes current literature on VTE incidence, associated risk factors, risk assessment tools, and primary thromboprophylaxis in PDAC patients treated with neoadjuvant chemo(radio)therapy.

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“…On the other hand, PDAC of the pancreatic tail (pancreatic tail cancer: PTC) initially only invades the splenic vein and/or artery, making them less likely to be borderline resectable [12] or unresectable due to locally-advanced disease. However, splenic vein occlusion can give rise to sinistral portal hypertension (SPH) and complications such as gastric varices (GV) [13]. SPH has been reported after pancreaticoduodenectomy involving splenic vein or SPC resection [14][15][16][17][18], but reports on SPH in unresectable PDAC are scarce [13].…”

Section: Introductionmentioning

confidence: 99%

“…However, splenic vein occlusion can give rise to sinistral portal hypertension (SPH) and complications such as gastric varices (GV) [13]. SPH has been reported after pancreaticoduodenectomy involving splenic vein or SPC resection [14][15][16][17][18], but reports on SPH in unresectable PDAC are scarce [13].…”

Section: Introductionmentioning

confidence: 99%

Splenic Hilar Involvement and Sinistral Portal Hypertension in Unresectable Pancreatic Tail Cancer

Okamoto,

Takeda,

Mie

et al. 2023

Cancers

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Background: Pancreatic tail cancer (PTC) frequently displays splenic hilar involvement (SHI), but its impact on clinical outcomes remains unclear. We investigated the clinical impact of SHI in patients with unresectable PTC. Methods: We retrospectively reviewed all patients with unresectable PTC who received first-line therapy at our institution from 2016 to 2020. Results: Of the 111 included patients, 48 had SHI at diagnosis. SHI was significantly associated with younger age, liver metastasis, peritoneal dissemination, larger tumor size, modified Glasgow prognostic score of 1 or more, splenic artery involvement, gastric varices, and splenomegaly. Shorter median overall survival (OS; 9.3 vs. 11.6 months, p = 0.003) and progression-free survival (PFS; 4.3 vs. 6.3 months, p = 0.013) were observed in SHI patients. Poor performance status of 1 or 2, tumor size > 50 mm, hepatic metastasis, mGPS of 1 or 2, and SHI (hazard ratio: 1.65, 95% confidence interval: 1.08–2.52, p = 0.020) were independent predictors of shorter OS. Splenic artery pseudoaneurysm rupture and variceal rupture were rare and only observed in cases with SHI. Conclusions: Splenic hilar involvement is associated with worse outcomes in pancreatic tail cancer.

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Portal hypertension caused by pancreatic cancer: Multidetector computed tomography diagnosis and multivariate analysis of variceal hemorrhage

Cited by 6 publications

References 0 publications

Clinical risk factors for ascites in metastatic pancreatic cancer

Clinical risk factors for ascites in metastatic pancreatic cancer

Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care

Splenic Hilar Involvement and Sinistral Portal Hypertension in Unresectable Pancreatic Tail Cancer

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