Ishigaki Kazunaga, Nakai Yousuke, Isayama Hiroyuki, Saito Kei, Hamada Tsuyoshi, Takahara Naminatsu, Mizuno Suguru, Mohri Dai, Kogure Hirofumi, Matsubara Saburo, Yamamoto Natsuyo, Tada Minoru, Koike Kazuhiko
From the Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Pancreas. 2017 Sep;46(8):1069-1075. doi: 10.1097/MPA.0000000000000889.
Pancreatic cancer is reported to be highly associated with thromboembolism (TE). The aim of this analysis is to clarify risk factors for TE and its clinical impact in Japanese patients with pancreatic cancer.
Data on consecutive pancreatic cancer patients receiving systemic chemotherapy between August 1999 and July 2015 were retrospectively studied. Both symptomatic and asymptomatic, arterial and venous TEs were included in the analysis. Risk factors for TE development were analyzed using a proportional hazards model with death without TE as a competing risk. The impact of TE on survival was also evaluated using a time-dependent covariate multiple Cox model.
A total of 475 patients were included in the analysis, and 57 TEs (12%) were identified: 45 venous TEs and 12 arterial TEs. The median time to TE was 169 days and the median survival from TE was 65 days. Liver metastasis was the only significant risk factor for TE (subdistribution hazards ratio, 2.15; P = 0.01), and TE was significantly associated with poor prognosis (hazards ratio, 3.31; P < 0.01).
Thromboembolism was not uncommon in Japanese patients receiving chemotherapy for advanced pancreatic cancer and was associated with poor prognosis. Liver metastasis was the risk factor for TE.
据报道，胰腺癌与血栓栓塞（TE）高度相关。本分析旨在阐明日本胰腺癌患者发生TE的危险因素及其临床影响。
对1999年8月至2015年7月期间接受全身化疗的连续性胰腺癌患者的数据进行回顾性研究。分析包括有症状和无症状的动脉和静脉TE。使用以无TE死亡作为竞争风险的比例风险模型分析TE发生的危险因素。还使用时间依赖性协变量多重Cox模型评估TE对生存的影响。
共有475例患者纳入分析，共识别出57例TE（12%）：45例静脉TE和12例动脉TE。发生TE的中位时间为169天，TE后的中位生存期为65天。肝转移是TE的唯一显著危险因素（亚分布风险比，2.15；P = 0.01），且TE与预后不良显著相关（风险比，3.31；P < 0.01）。
在接受化疗的日本晚期胰腺癌患者中，血栓栓塞并不少见，且与预后不良相关。肝转移是TE的危险因素。
