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Impact of venous thromboembolism on the natural history of pancreatic adenocarcinoma

Hepatobiliary & Pancreatic Diseases International 2015年第4期14卷 436-442页

作者： Mehdi Oua?ssi Cécilia Frasconi Diane Mege laurence panicot-dubois laurence Boiron Laetitia Dahan Philippe Debourdeau Christophe dubois Dominique Farge Igor Sielezneff Departments of Digestive Surgery Timone Hospital Aix-Marseille University Atelier Proven?ale d'Ecriture Médicale Faculté de Médecine de Marseille Groupe Francophone Thrombose et Cancer H?pital ST Louis 1 avenue Claude VellefauxParis France INSERM UMR-1076 Faculty of Pharmacy Aix-Marseille University Departments of Oncology Timone Hospital Aix-Marseille University Department of Hematology Hospital Sainte Catherine INSERM UMR-1160 Internal Medicine and Vascular Unit Assistance PubliqueH?pitaux de Paris

Few studies have analyzed the effect of ve- nous thromboembolism （VTE） events on the prognosis of pancreatic cancer, but their results were conflicting. The pres- ent 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 histologi- cal 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 demonstratedVTE （＋）. PA patients with and without PE were similar for age, American Society of Anesthesiologist score, body mass index, and histo- ry of treatment. The distribution of cancer stages was similarbetween the two groups VTE （＋） and VTE （-）. The median du- ration 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. CONCLUSION： VTE （＋） at time of diagnosis or within the first 3 months after surgery during treatment is an indepen- dent factor of poor prognosis in PA.

关键词： pancreatic carcinoma thromboembolism survival

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