Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.
Gut Liver. 2024 Jan 15;18(1):165-173. doi: 10.5009/gnl220477. Epub 2023 Apr 3.
BACKGROUND/AIMS: Patients with active cancer frequently develop venous thromboembolism (VTE). However, there is little data about VTE in patients with advanced cholangiocarcinoma (CCA). Therefore, we investigated the clinical significance of VTE in patients with advanced CCA.
We analyzed the data of a total of 332 unresectable CCA patients diagnosed between 2010 and 2020 in this retrospective study. We investigated the incidence and risk factors for VTE, and its effect on survival in patients with advanced CCA.
During a median follow-up of 11.6 months, 118 patients (35.5%) developed VTE. The cumulative incidence of VTE was 22.4% (95% confidence interval [CI], 0.18 to 0.27) at 3 months and 32.8% (95% CI, 0.27 to 0.38) at 12 months. Major vessel invasion was an independent risk factor for VTE (hazard ratio, 2.88; 95% CI, 1.92 to 4.31; p<0.001). Patients who developed VTE during follow-up had shorter overall survival than patients who did not (11.50 months vs 15.83 months, p=0.005). In multivariable analysis, VTE (hazard ratio, 1.58; 95% CI, 1.23 to 2.02; p<0.001) was associated with poor overall survival.
Major vessel invasion is related to the occurrence of VTE in advanced CCA. The development of VTE significantly decreases the overall survival and is an important unfavorable prognostic factor for survival.
背景/目的：患有活动性癌症的患者常发生静脉血栓栓塞症（VTE）。然而，关于晚期胆管癌（CCA）患者的 VTE 数据很少。因此，我们研究了 VTE 在晚期 CCA 患者中的临床意义。
我们在这项回顾性研究中分析了 2010 年至 2020 年间共 332 例不可切除的 CCA 患者的数据。我们研究了 VTE 的发生率和危险因素，以及其对晚期 CCA 患者生存的影响。
在中位随访 11.6 个月期间，118 例患者（35.5%）发生了 VTE。VTE 的累积发生率在 3 个月时为 22.4%（95%置信区间 [CI]，0.18 至 0.27），在 12 个月时为 32.8%（95% CI，0.27 至 0.38）。大血管侵犯是 VTE 的独立危险因素（风险比，2.88；95% CI，1.92 至 4.31；p<0.001）。在随访期间发生 VTE 的患者的总生存期短于未发生 VTE 的患者（11.50 个月比 15.83 个月，p=0.005）。在多变量分析中，VTE（风险比，1.58；95% CI，1.23 至 2.02；p<0.001）与总体生存不良相关。
大血管侵犯与晚期 CCA 中 VTE 的发生有关。VTE 的发生显著降低了总生存期，是影响生存的重要不良预后因素。
