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Burden of venous thromboembolism in patients with pancreatic cancer

World Journal of Gastroenterology 2021年第19期27卷 2325-2340页

作者： Corinne Frere Department of Haematology Pitie-Salpetriere HospitalAssistance Publique Hopitaux de ParisParis F-75013France INSERM UMRS_1166 Institute of Cardiometabolism And NutritionGRC 27 GRECOSorbonne UniversitéParis F-75013France groupe francophone thrombose et cancer Saint-Louis HospitalParis F-75010France

Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after *** thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care *** management of VTE is particularly challenging in these frail *** selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment *** International Initiative on Thrombosis and cancer multi-language web-based mobile application(downloadable for free at ***)has been developed to help clinicians in decision making in the most complex *** this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.

关键词： Pancreatic cancer Venous thromboembolism Low-molecular weight heparin Direct oral anticoagulant Multi-language mobile application Risk-assessment models Thromboprophylaxis

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Impact of venous thromboembolism on the natural history of pancreatic adenocarcinoma

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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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What make differences in the outcome of adjuvant treatments for resected gastric cancer?

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World Journal of Gastroenterology 2014年第33期20卷 11567-11573页

作者： Toshifusa Nakajima Masashi Fujii Department of Gastrointestinal Surgery Cancer Institute Ariake Hospital Tokyo 135-8550 Japan The vice president Japan Cancer Clinical Research Organization (JACCRO) Chuo-ku Tokyo 104-0061 Japan Department of Surgery Nihon University Surugadai Hospital Tokyo 101-0062 Japan

After a long history of Dark Age of adjuvant chemotherapy for gastric cancer, definite evidences of survival benefit from adjuvant treatment have been reported since 2000 s. These survival benefits are likely attributed to something new approach different from pervious studies. In 2001, South West Oncology Group INT0116 trial yielded survival benefit in curatively resected gastric cancer patients with postoperative chemoradiotherapy [5-fluorouracil(5-FU) + Leucovorin + radiotherapy], followed by positive result by MAGIC Trial, employing perioperative(pre- and postoperative chemotherapy with Epirubicin, cisplatin(CDDP), 5-fluorouracil(ECF) regimen in patients with curative resection. A novel drug [S1: ACTS-GC(Adjuvant chemotherapy trial of TS-1 for gastric cancer) in 2007], or new drug combination chemotherapys [CDDP + 5-FU: FNCLCC/FFCD(Federation Nationale des Centres de Lutte contre le cancer/Federation francophone de cancerologie Digestive) in 2011, Capecitabine + Oxaliplatin: CLASSIC in 2012] also produced positive results in terms of improved prognosis. Neoadjuvant or perioperative chemotherapy, novel anti-cancer drugs, and chemoradiotherapy might be the key words to develop further improvement in the adjuvant treatment of resectable gastric cancer. Moreover, it is not new but still true to stress the importance of D2 surgery as the baseline treatment in order to minimize the amount of residual tumor after surgery.

关键词： Resected gastric cancer Phase Ⅲ clinical trial Adjuvant and neo-adjuvant therapy Chemoradio-therapy Review

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转移性胃癌患者的长期生活质量研究:消化道肿瘤II期随机试验中生活质量的分析模式及临床适用范围

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世界核心医学期刊文摘（胃肠病学分册） 2006年第5期2卷 33-34页

作者： Bonnetain F. Bouché O. Conroy T. 张欣 INSERM EMI 106 Federation Francophone de Cancerologie Digestive Faculty of Medicine 7 Bd Jeanne d'Arc 21079 Dijon Cedex

Objectives-The aim of this study was to compare the longitudinal quality of life (QoL) between LV5FU2-irinotecan and LV5FU2 alone or LV5FU2-cisplatin in a randomized Phase II trial in patients with metastatic gastric adenocarcinoma. Methods-Among 134 eligible patients, QLQ-C30 scores were collected and described at each 2 monthly follow-up visit during 6 months. The frequencies of QLQ-C30 score improvement were calculated and mixed models for repeated measurements were applied with or without extreme poorest imputation for missing scores. The “ survival” until definitive global health score (GHS) deterioration was estimated. Results-At the 3rd follow-up, patients with a stable or improved global health ranged from 11% in the LV5FU2-cisplatin arm to 18% in the LV5FU2-irinotecan arm. The irinotecan-based-therapy presented 14 to 15 scores with a better QoL. The time until definitive GHS deterioration was globally similar between treatment arms. Conclusion-This study highlights a better impact of LV5FU2-irinotecan and the interest of QoL assessment in phase II trials to complement the risk-benefit judgement.

关键词：胃癌患者生活质量 Ⅱ期试验随机试验转移性消化道肿瘤质量研究依立替康适用临床

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