Key result
In patients with metastatic pancreatic cancer, advanced stage disease was significantly associated with an increased risk of venous thromboembolism (OR 3.7, p=0.001).
Why the study?
Pancreatic cancer carries a high risk of VTE, but risk assessment models predicting benefit of thromboprophylaxis have not been verified in metastatic pancreatic cancer.
Does the occurrence of venous thromboembolism affect overall survival in patients with metastatic pancreatic cancer?
Cohort (n=400)
No
Does the occurrence of venous thromboembolism affect overall survival in patients with metastatic pancreatic cancer?
Odds Ratio: 3.7
p-value: p=0.001
Metastatic pancreatic cancer carries a significant VTE burden (17.5%), which predicts poorer overall survival.
VTE burden in mPC warrants clinical vigilance without altering prophylaxis; leaves open prospective RAM validation.
BACKGROUND: Pancreatic cancer (PC) carries a high risk of venous thromboembolism (VTE). Several risk assessment models (RAMs) predict benefit of thromboprophylaxis in solid tumors; however, none are verified in metastatic pancreatic cancer (mPC). METHODS: A retrospective mPC cohort treated at an academic cancer center from 2010 to 2016 was investigated for VTE incidence (VTEmets). Multivariable regression analysis was used to assess multiple VTE risk factors. Overall survival (OS) was compared between mPC groups with and without VTE. Survival was analyzed using Kaplan-Meier survival plots and Cox proportional hazards regressions. RESULTS: 400 mPC patients (median age 66; 52% males) were included. 87% had performance status of ECOG 0-1; 70% had advanced stage at PC diagnosis. Incidence of VTEmets was 17.5%; median time of occurrence 3.48 months after mPC diagnosis. Survival analysis started at median VTE occurrence. Median OS was 10.5 months in VTEmets vs. 13.4 in non-VTE group. Only advanced stage (OR 3.7, p = .001) correlated with increased VTE risk. CONCLUSIONS: The results suggest mPC carries a significant VTE burden. VTE predicts poor outcomes from the point of median VTE occurrence. Advanced stage disease is the strongest risk factor. Future studies are needed to define risk stratification, survival benefit, and choice of thromboprophylaxis.
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Laderman et al. (2023) conducted a cohort in Metastatic pancreatic cancer (n=400). Advanced stage disease vs. Non-advanced stage disease was evaluated on Venous thromboembolism (VTE) (OR 3.7, p=0.001). In patients with metastatic pancreatic cancer, advanced stage disease was significantly associated with an increased risk of venous thromboembolism (OR 3.7, p=0.001).
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