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Erschienen in: Clinical and Translational Oncology 10/2014

01.10.2014 | Brief Research Article

Incidence of venous thromboembolism (VTE) in ambulatory pancreatic cancer patients receiving chemotherapy and analysis of Khorana’s predictive model

verfasst von: A. J. Muñoz Martín, P. García Alfonso, A. B. Rupérez Blanco, S. Pérez Ramírez, M. Blanco Codesido, M. Martín Jiménez

Erschienen in: Clinical and Translational Oncology | Ausgabe 10/2014

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Abstract

Purpose

To evaluate the incidence of venous thromboembolism (VTE) in ambulatory pancreas cancer patients receiving chemotherapy and analyze Khorana’s predictive model of chemotherapy-associated thrombosis.

Methods/patients

We performed a retrospective review to determine the incidence of VTE in the gastrointestinal cancer unit of our center. Between 2008 and 2011, 84 consecutives patients diagnosed with pancreas adenocarcinoma were identified and included in the analysis. Pancreatic neuroendocrine tumors were excluded.

Results

Thirty patients experienced VTE (35.7 %) and 66 % of the events were diagnosed during the first 6 months after diagnosis. Khorana’s score: 33.3 % of the intermediate category patients developed a venous thromboembolic event and 37.5 % in the high-risk category.

Conclusions

The high incidence of VTE observed in this study is consistent with prior reports. Specific predictive model for chemotherapy-associated thrombosis in pancreatic cancer must be investigated.
Literatur
1.
Zurück zum Zitat Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5:632–4.PubMedCrossRef Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5:632–4.PubMedCrossRef
3.
Zurück zum Zitat Menapace LA, Peterson DR, Berry A, Sousou T, Khorana AA. Symptomatic and incidental thromboembolism are both associated with mortality in pancreatic cancer. Thromb Haemost. 2011;106:371–8.PubMedCrossRef Menapace LA, Peterson DR, Berry A, Sousou T, Khorana AA. Symptomatic and incidental thromboembolism are both associated with mortality in pancreatic cancer. Thromb Haemost. 2011;106:371–8.PubMedCrossRef
4.
Zurück zum Zitat Epstein AS, Soff GA, Capanu M, Crosbie C, Shah MA, Kelsen DP, et al. Analysis of incidence and clinical outcomes in patients with thromboembolic events and invasive exocrine pancreatic cancer. Cancer. 2012;118:3053–61.PubMedCrossRef Epstein AS, Soff GA, Capanu M, Crosbie C, Shah MA, Kelsen DP, et al. Analysis of incidence and clinical outcomes in patients with thromboembolic events and invasive exocrine pancreatic cancer. Cancer. 2012;118:3053–61.PubMedCrossRef
5.
Zurück zum Zitat Blom JW, Vanderschoot JP, Oostindier MJ, Osanto S, van der Meer FJ, Rosendaal FR. Incidence of venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost. 2006;4:529–35.PubMedCrossRef Blom JW, Vanderschoot JP, Oostindier MJ, Osanto S, van der Meer FJ, Rosendaal FR. Incidence of venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost. 2006;4:529–35.PubMedCrossRef
6.
Zurück zum Zitat Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902–7.PubMedCrossRefPubMedCentral Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902–7.PubMedCrossRefPubMedCentral
7.
Zurück zum Zitat den Exter PL, Hooijer J, Dekkers OM, Huisman MV. Risk of recurrent venous thromboembolism and mortality in patients with cancer incidentally diagnosed with pulmonary embolism: a comparison with symptomatic patients. J Clin Oncol. 2011;29(17):2405–9.CrossRef den Exter PL, Hooijer J, Dekkers OM, Huisman MV. Risk of recurrent venous thromboembolism and mortality in patients with cancer incidentally diagnosed with pulmonary embolism: a comparison with symptomatic patients. J Clin Oncol. 2011;29(17):2405–9.CrossRef
8.
Zurück zum Zitat Khorana AA. Risk assessment for cancer-associated thrombosis: what is the best approach? Thromb Res. 2012;129(Suppl 1):S10–5.PubMedCrossRef Khorana AA. Risk assessment for cancer-associated thrombosis: what is the best approach? Thromb Res. 2012;129(Suppl 1):S10–5.PubMedCrossRef
9.
Zurück zum Zitat Agnelli G, George DJ, Kakkar AK, Fisher W, Lassen MR, Mismetti P, et al. Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer. N Engl J Med. 2012;366:601–9.PubMedCrossRef Agnelli G, George DJ, Kakkar AK, Fisher W, Lassen MR, Mismetti P, et al. Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer. N Engl J Med. 2012;366:601–9.PubMedCrossRef
10.
Zurück zum Zitat Agnelli G, Gussoni G, Bianchini C, Verso M, Mandalà M, Cavanna L, et al. Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study. Lancet Oncol. 2009;10:943–9.PubMedCrossRef Agnelli G, Gussoni G, Bianchini C, Verso M, Mandalà M, Cavanna L, et al. Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study. Lancet Oncol. 2009;10:943–9.PubMedCrossRef
11.
Zurück zum Zitat Riess H, Pelzer U, Opitz B, Stauch P, Reitzig S, Hahnfeld, et al. A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy: final results of the CONKO-004 trial. ASCO Annual Meeting Abstracts. J Clin Oncol. 2010;28(15 Suppl) [abstr. 4033]. Riess H, Pelzer U, Opitz B, Stauch P, Reitzig S, Hahnfeld, et al. A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy: final results of the CONKO-004 trial. ASCO Annual Meeting Abstracts. J Clin Oncol. 2010;28(15 Suppl) [abstr. 4033].
12.
Zurück zum Zitat Maraveyas A, Waters J, Roy R, Fyfe D, Propper D, Lofts F, et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer. 2012;48:1283–92.PubMedCrossRef Maraveyas A, Waters J, Roy R, Fyfe D, Propper D, Lofts F, et al. Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. Eur J Cancer. 2012;48:1283–92.PubMedCrossRef
13.
Zurück zum Zitat Lyman GH, Khorana AA, Falanga A, Clarke-Pearson D, Flowers C, Jahanzeb M, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol. 2007;25:5490–505.PubMedCrossRef Lyman GH, Khorana AA, Falanga A, Clarke-Pearson D, Flowers C, Jahanzeb M, et al. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol. 2007;25:5490–505.PubMedCrossRef
14.
Zurück zum Zitat Mandalà M, Falanga A, Roila F. Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2011;22(Suppl 6):vi 85–92. Mandalà M, Falanga A, Roila F. Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2011;22(Suppl 6):vi 85–92.
15.
Zurück zum Zitat Muñoz AJ, Viñolas N, Cubedo R, Isla D. SEOM guidelines on thrombosis in cancer patients. Clin Transl Oncol. 2011;13:592–6.PubMedCrossRef Muñoz AJ, Viñolas N, Cubedo R, Isla D. SEOM guidelines on thrombosis in cancer patients. Clin Transl Oncol. 2011;13:592–6.PubMedCrossRef
16.
Zurück zum Zitat Lyman GH, Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2189–204.PubMedCrossRef Lyman GH, Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2189–204.PubMedCrossRef
17.
Zurück zum Zitat Khorana AA, Dalal M, Lin J, Connolly GC. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2012;119:648–55.PubMedCrossRef Khorana AA, Dalal M, Lin J, Connolly GC. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2012;119:648–55.PubMedCrossRef
18.
Zurück zum Zitat Ay C, Dunkler D, Marosi C, Chiriac AL, Vormittag R, Simanek R, et al. Prediction of venous thromboembolism in cancer patients. Blood. 2010;116:5377–82.PubMedCrossRef Ay C, Dunkler D, Marosi C, Chiriac AL, Vormittag R, Simanek R, et al. Prediction of venous thromboembolism in cancer patients. Blood. 2010;116:5377–82.PubMedCrossRef
19.
Zurück zum Zitat Kearney JC, Rossi S, Glinert K, Henry DH. Venous thromboembolism (VTE) and survival in a cancer chemotherapy outpatient clinic: a retrospective chart validation of a VTE prediction model. In: Proceedings of the 52th American Society of Hematology (ASH) Annual Meeting, 5–8 Dec 2009; New Orleans, Louisiana (Abstract 2503). Kearney JC, Rossi S, Glinert K, Henry DH. Venous thromboembolism (VTE) and survival in a cancer chemotherapy outpatient clinic: a retrospective chart validation of a VTE prediction model. In: Proceedings of the 52th American Society of Hematology (ASH) Annual Meeting, 5–8 Dec 2009; New Orleans, Louisiana (Abstract 2503).
20.
Zurück zum Zitat Price LH, Nguyen MB, Picozzi VJ, Kozarek RA. Portal vein thrombosis in pancreatic cancer: natural history, risk factors and implications for patient management. In: Proceedings of the 7th Gastrointestinal Cancer Symposium, 22–24 Jan 2010; Orlando, Florida (Abstract 143). Price LH, Nguyen MB, Picozzi VJ, Kozarek RA. Portal vein thrombosis in pancreatic cancer: natural history, risk factors and implications for patient management. In: Proceedings of the 7th Gastrointestinal Cancer Symposium, 22–24 Jan 2010; Orlando, Florida (Abstract 143).
Metadaten
Titel
Incidence of venous thromboembolism (VTE) in ambulatory pancreatic cancer patients receiving chemotherapy and analysis of Khorana’s predictive model
verfasst von
A. J. Muñoz Martín
P. García Alfonso
A. B. Rupérez Blanco
S. Pérez Ramírez
M. Blanco Codesido
M. Martín Jiménez
Publikationsdatum
01.10.2014
Verlag
Springer Milan
Erschienen in
Clinical and Translational Oncology / Ausgabe 10/2014
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-014-1165-y

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