Role of anticoagulation in the management of pancreatic cancer.

Pancreatic cancer remains a major clinical challenge. Recent advances in chemotherapeutic and targeted agents have offered a modest survival benefit. One of the major complications of pancreatic cancer is venous thromboembolism. Although it is well-known fact that patients with mucinous carcinoma of the pancreas and gastrointestinal tract pose an increased risk of developing thromboembolic complications, scarce data exists regarding the incidence and pathogenesis of venous thromboembolism in pancreatic cancer patients. The incidence of venous thromboembolism in pancreatic cancer patients ranges from 17% to 57%. Clinical data also suggest that the occurrence of venous thromboembolism may be associated with poorer prognosis in such patients. Recent data suggest that anticoagulant treatments may improve cancer patient survival by decreasing thromboembolic complications as well as by anticancer effects. Thromboembolic disease in pancreatic cancer presents a life-threatening complication and is regarded as paraneoplastic manifestation of the disease. Effective management of this risk factor is very important in the management of pancreatic cancer. Given the lack of extensive data and the clinical relevance of this topic for both physicians and basic research scientists, the authors review the incidence, pathogenesis and clinical implications of venous thromboembolism in pancreatic cancer patients.