Department of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan;
Department of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Anticancer Res. 2023 Apr;43(4):1741-1747. doi: 10.21873/anticanres.16327.
BACKGROUND/AIM: Pancreatic cancer has the highest risk of venous thromboembolism (VTE). Additionally, chemotherapy for cancer patients increases the risk of developing VTE. Due to recent advances in neoadjuvant chemotherapy (NAC) regimens, more patients with resectable pancreatic cancer will receive NAC. However, the incidence, risk, and predictors of developing VTE in these patients have not been fully evaluated.
We retrospectively evaluated the incidence, risk, and predictors of VTE among 67 consecutive patients with resectable pancreatic cancer who received neoadjuvant combination therapy with gemcitabine+S-1 (NAC-GS) followed by surgery and 45 patients with resectable pancreatic cancer who underwent upfront surgery (Up-S).
The incidence of VTE in the NAC-GS and Up-S groups was 10.4% and 6.6%, respectively. Preoperative D-dimer levels were significantly higher in the NAC-GS group, and D-dimer levels were significantly increased during NAC-GS. Preoperative D-dimer level was the only predictor for VTE in patients with resectable pancreatic cancer who received NAC-GS.
There is an increased risk of developing VTE during NAC. Screening with D-dimer and taking appropriate measures to suppress critical VTE is essential to provide NAC to patients with resectable pancreatic cancer.
背景/目的：胰腺癌具有发生静脉血栓栓塞症（VTE）的最高风险。此外，癌症患者的化疗会增加发生 VTE 的风险。由于新辅助化疗（NAC）方案的最近进展，更多可切除胰腺癌患者将接受 NAC。然而，这些患者发生 VTE 的发生率、风险和预测因素尚未得到充分评估。
我们回顾性评估了 67 例接受吉西他滨+S-1（NAC-GS）联合治疗后接受手术的可切除胰腺癌患者（NAC-GS 组）和 45 例接受直接手术的可切除胰腺癌患者（Up-S 组）中 VTE 的发生率、风险和预测因素。
NAC-GS 组和 Up-S 组的 VTE 发生率分别为 10.4%和 6.6%。NAC-GS 组患者术前 D-二聚体水平明显升高，且 NAC-GS 期间 D-二聚体水平显著升高。术前 D-二聚体水平是接受 NAC-GS 的可切除胰腺癌患者发生 VTE 的唯一预测因素。
NAC 期间发生 VTE 的风险增加。对 D-二聚体进行筛查并采取适当措施抑制关键 VTE 对为可切除胰腺癌患者提供 NAC 至关重要。
