Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
Korean J Gastroenterol. 2023 Mar 25;81(3):109-120. doi: 10.4166/kjg.2022.137.
BACKGROUND/AIMS: This study evaluated the incidence of venous thromboembolism (VTE) in patients with advanced pancreatic ductal adenocarcinoma (PDAC) at the authors' institution and analyzed the risk factors associated with VTE and the overall survival (OS).
One hundred and seventy patients with locally advanced or metastatic PDAC who received palliative chemotherapy at Daegu Catholic University Medical Center from January 2011 to December 2020 were included.
During a median follow-up period of 341 days, 24 patients (14.1%) developed VTE. Cumulative incidence values of VTE were 4.7% (95% confidence interval [CI], 2.39-9.22) at 90 days, 9.9% (95% CI, 6.14-15.59) at 180 days, and 16.9% (95% CI, 11.50-24.36) at 360 days. Multivariate analysis showed that a carbohydrate antigen 19-9 (CA 19-9) level over 1,000 U/mL (hazard ratio [HR], 2.666; 95% CI, 1.112-6.389; p=0.028) and a history of alcohol consumption (HR, 0.327; 95% CI, 0.109-0.981; p=0.046) were significant factors associated with VTE. Patients with VTE showed a shorter median survival (347 days vs. 556 days; p=0.041) than those without VTE. Multivariate analysis revealed VTE (HR, 1.850; 95% CI, 1.049-3.263; p=0.033) and CA 19-9 level over 1,000 U/mL (HR, 1.843; 95% CI, 1.113-3.052; p=0.017) to be significant risk factors associated with OS.
The cumulative incidence of VTE in patients with advanced PDAC was 16.9% at 360 days. While a history of alcohol consumption was a protective factor, a high CA19-9 level was a risk factor for VTE. In addition, the occurrence of VTE was associated with poor prognosis.
背景/目的：本研究评估了作者所在机构晚期胰腺导管腺癌（PDAC）患者静脉血栓栓塞（VTE）的发生率，并分析了与 VTE 相关的危险因素以及总生存期（OS）。
纳入了 2011 年 1 月至 2020 年 12 月在大邱天主教大学医疗中心接受姑息化疗的 170 例局部晚期或转移性 PDAC 患者。
在中位随访 341 天期间，24 例（14.1%）发生 VTE。VTE 的累积发生率值在 90 天为 4.7%（95%置信区间[CI]，2.39-9.22），180 天为 9.9%（95% CI，6.14-15.59），360 天为 16.9%（95% CI，11.50-24.36）。多变量分析显示，CA19-9 水平>1000 U/mL（危险比[HR]，2.666；95% CI，1.112-6.389；p=0.028）和饮酒史（HR，0.327；95% CI，0.109-0.981；p=0.046）是与 VTE 相关的显著因素。发生 VTE 的患者中位生存期（347 天）短于未发生 VTE 的患者（556 天）（p=0.041）。多变量分析显示 VTE（HR，1.850；95% CI，1.049-3.263；p=0.033）和 CA19-9 水平>1000 U/mL（HR，1.843；95% CI，1.113-3.052；p=0.017）是与 OS 相关的显著危险因素。
晚期 PDAC 患者 VTE 的累积发生率为 360 天时为 16.9%。虽然饮酒史是保护因素，但高 CA19-9 水平是 VTE 的危险因素。此外，VTE 的发生与预后不良相关。
