Korean J Med.  2018 Oct;93(5):457-463. 10.3904/kjm.2018.93.5.457.

Thromboembolic Events as Prognostic Clinical Markers in Advanced Pancreatic and Biliary Tract Cancer

• Shin K
• Lee MA

• KMID: 2446988
• DOI: http://doi.org/10.3904/kjm.2018.93.5.457

Abstract

BACKGROUND/AIMS
Venous thromboembolic events (VTEs) are common events in patients with advanced cancer. We analyzed the clinical characteristics of VTEs in advanced pancreatic and biliary tract cancer to determine the clinical significance, especially in palliative settings.
METHODS
Seventy-nine patients with advanced pancreatic cancer or biliary tract cancer who had thromboembolic events were retrospectively reviewed. We investigated the correlation between clinical course and thromboembolic events, and the laboratory risk factors, such as complete blood count profile.
RESULTS
The 79 patients consisted of 40 men (50.6%) and 39 women (49.4%) with a median age of 65 years old (range: 41-80). Forty-three patients (54.4%), had thromboembolic events without any symptoms. Pulmonary thromboembolism occurred in only 31 cases (39.2%), and combined thrombosis at more than two sites occurred in 17 cases (21.5%). Of the 51 patients with active chemotherapy, 45 showed progressive disease. The median survival times were 11.9 weeks in all patients, 15.3 weeks in the treatment group, and 3.4 weeks in the palliative group. There was no difference in survival time between patients treated with dalteparin only and those treated with dalteparin combined with thrombolytic intervention.
CONCLUSIONS
VTE can be poor prognostic indicator in pancreatic and biliary tract cacner patients, suggestive of progressive disease and a sign of short life expectancy, requiring hospice and terminal care.

Keyword

Pancreatic cancer; Biliary tract cancer; Venous thromboembolism; Prognostic factor

MeSH Terms

Biliary Tract Neoplasms*
Biliary Tract*
Biomarkers*
Blood Cell Count
Dalteparin
Drug Therapy
Female
Hospices
Humans
Life Expectancy
Male
Pancreatic Neoplasms
Pulmonary Embolism
Retrospective Studies
Risk Factors
Terminal Care
Thrombosis
Venous Thromboembolism
Biomarkers
Dalteparin