Impact of venous thromboembolism on the natural history of pancreatic adenocarcinoma
Mehdi Ouaissi, Cécilia Frasconi, Diane Mege, Laurence Panicot-dubois, Laurence Boiron, Laetitia Dahan, Philippe Debourdeau, Christophe Dubois, Dominique Farge and Igor Sielezneff
Marseille, France
Author Affiliations: Departments of Digestive Surgery (Ouaissi M, Frasconi C, Mege D, Boiron L and Sielezneff I) and Oncology (Dahan L), Timone Hospital, Aix-Marseille University, Marseille, France; Atelier Provencale d'Ecriture Medicale, Faculte de Medecine de Marseille (Ouaissi M, Frasconi C and Mege D); Groupe Francophone Thrombose et Cancer, Hopital ST Louis, 1 avenue Claude Vellefaux, Paris, France (Ouaissi M, Mege D, Panicot-dubois L, Debourdeau P, Dubois C and Farge D); INSERM UMR-1076, Faculty of Pharmacy, Aix-Marseille University, Marseille, France (Mege D, Panicot-dubois L and Dubois C) and INSERM UMR-1160, Internal Medicine and Vascular Unit, Assistance Publique-Hopitaux de Paris, Paris, France (Farge D); Department of Hematology, Hospital Sainte Catherine, Avignon, France (Debourdeau P)
Corresponding Author: Mehdi Ouaissi, MD, PhD, Department of Digestive Surgery, Timone Hospital, 264 rue saint Pierre, 13385 Marseille, France (Tel: +33-4913885852; Fax: +33-4913885552; Email: mehdi.ouaissi@ mail.ap-hm.fr)
BACKGROUND: Few studies have analyzed the effect of venous thromboembolism (VTE) events on the prognosis of pancreatic cancer, but their results were conflicting. The present 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 histological 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 demonstrated VTE (+). PA patients with and without PE were similar for age, American Society of Anesthesiologist score, body mass index, and history of treatment. The distribution of cancer stages was similar between the two groups VTE (+) and VTE (-). The median duration 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 independent factor of poor prognosis in PA.
2015, Vol. 14 
