Gut Liver.  2024 Jan;18(1):165-173. 10.5009/gnl220477.

Clinical Significance of Venous Thromboembolism in Patients with Advanced Cholangiocarcinoma

• Kim JS
• Paik WH
• Lee SH
• Lee MW
• Park N
• Choi JH
• Cho IR
• Ryu JK
• Kim YT

• KMID: 2551046
• DOI: http://doi.org/10.5009/gnl220477

Abstract

Background/Aims
Patients with active cancer frequently develop venous thromboembolism (VTE). However, there is little data about VTE in patients with advanced cholangiocarcinoma (CCA). Therefore, we investigated the clinical significance of VTE in patients with advanced CCA.
Methods
We analyzed the data of a total of 332 unresectable CCA patients diagnosed between 2010 and 2020 in this retrospective study. We investigated the incidence and risk factors for VTE, and its effect on survival in patients with advanced CCA.
Results
During a median follow-up of 11.6 months, 118 patients (35.5%) developed VTE. The cumulative incidence of VTE was 22.4% (95% confidence interval [CI], 0.18 to 0.27) at 3 months and 32.8% (95% CI, 0.27 to 0.38) at 12 months. Major vessel invasion was an independent risk factor for VTE (hazard ratio, 2.88; 95% CI, 1.92 to 4.31; p<0.001). Patients who developed VTE during follow-up had shorter overall survival than patients who did not (11.50 months vs 15.83 months, p=0.005). In multivariable analysis, VTE (hazard ratio, 1.58; 95% CI, 1.23 to 2.02; p<0.001) was associated with poor overall survival.
Conclusions
Major vessel invasion is related to the occurrence of VTE in advanced CCA. The development of VTE significantly decreases the overall survival and is an important unfavorable prognostic factor for survival.

Keyword

Venous thromboembolism; Cholangiocarcinoma; Prognostic factor; Advanced stage