Hospital Beatriz Ângelo, Loures, Portugal.
Hospital da Luz, Lisboa, Portugal.
Oncologist. 2020 Feb;25(2):e284-e290. doi: 10.1634/theoncologist.2019-0510. Epub 2019 Oct 22.
Venous thromboembolism (VTE) is a frequent complication in patients with cancer and causes considerable morbidity and mortality. The risk of VTE is higher in patients with pancreatic cancer and is often associated with treatment delays or interruptions. Recently, the ONKOTEV score was proposed as a VTE risk predictor model for patients with cancer, but its validation is still ongoing.
We conducted a retrospective study to determine the incidence of VTE and to evaluate the ONKOTEV score as a VTE predictive tool in a population of patients with pancreatic cancer.
Between February 2012 and May 2017, 165 patients were included in the study. The median age was 73 years, 45.5% of patients were female, and 55.8% had stage IV disease. Fifty-one patients had a VTE (30.9%); 23.5% had pulmonary embolism, 25.5% had deep venous thrombosis, and 51.0% had visceral VTE (VsT). At a median follow-up time of 6.3 months, cumulative incidence of VTE was less than 10% for ONKOTEV scores 0 or 1 and approximately 40% and 70% for scores 2 and ≥3, respectively.
The high VTE incidence observed in this study is consistent with prior reports. Patients at high risk for VTE with no increase in hemorrhagic risk should be considered for primary thromboprophylaxis. The ONKOTEV score may stratify VTE risk in patients with pancreatic cancer, with ONKOTEV score ≥2 being associated with a higher VTE occurrence.
Venous thromboembolism (VTE) is a frequent complication of patients with pancreatic cancer and causes considerable morbidity, treatment delays or interruptions, and mortality. Thromboprophylaxis is not used routinely in ambulatory patients. Tools to stratify the risk of VTE are important to help select patients who may benefit from thromboprophylaxis. Recently, the ONKOTEV score was proposed as a VTE risk predictor model for patients with cancer, but its validation is still ongoing. In this patient series, ONKOTEV score ≥2 was associated with high VTE occurrence and may stratify VTE risk in patients with pancreatic cancer, suggesting that ONKOTEV can be considered to select patients with pancreatic cancer for primary thromboprophylaxis.
静脉血栓栓塞症（VTE）是癌症患者的常见并发症，会导致相当高的发病率和死亡率。胰腺癌患者的 VTE 风险更高，并且常常与治疗延迟或中断有关。最近，ONKOTEV 评分被提出作为癌症患者的 VTE 风险预测模型，但它的验证仍在进行中。
我们进行了一项回顾性研究，以确定 VTE 的发生率，并评估 ONKOTEV 评分作为胰腺癌患者 VTE 预测工具的有效性。
在 2012 年 2 月至 2017 年 5 月期间，共有 165 名患者纳入了这项研究。中位年龄为 73 岁，45.5%的患者为女性，55.8%的患者为 IV 期疾病。51 名患者出现 VTE（30.9%）；23.5%的患者发生肺栓塞，25.5%的患者发生深静脉血栓形成，51.0%的患者发生内脏静脉血栓形成（VsT）。在中位随访时间为 6.3 个月时，ONKOTEV 评分为 0 或 1 的患者的 VTE 累积发生率不到 10%，而评分为 2 和≥3 的患者的 VTE 发生率分别约为 40%和 70%。
本研究观察到的高 VTE 发生率与既往报告一致。无出血风险增加的高危 VTE 患者应考虑进行一级预防。ONKOTEV 评分可能对胰腺癌患者的 VTE 风险进行分层，ONKOTEV 评分≥2 与更高的 VTE 发生率相关。
静脉血栓栓塞症（VTE）是胰腺癌患者的常见并发症，会导致相当高的发病率、治疗延迟或中断以及死亡率。在门诊患者中，常规使用抗血栓药物预防 VTE 并不常见。用于分层 VTE 风险的工具对于帮助选择可能受益于抗血栓药物治疗的患者非常重要。最近，ONKOTEV 评分被提出作为癌症患者的 VTE 风险预测模型，但它的验证仍在进行中。在本患者系列中，ONKOTEV 评分≥2 与高 VTE 发生率相关，可能对胰腺癌患者的 VTE 风险进行分层，提示 ONKOTEV 可用于选择胰腺癌患者进行一级预防。
