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癌症-静脉血栓栓塞症登记处胰腺癌亚组的静脉血栓栓塞症发生率和风险因素。

Incidence and risk factors for venous thromboembolism in the Cancer-VTE Registry pancreatic cancer subcohort.

机构信息

Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.

Department of Hepatobiliary-Pancreatic Surgery, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.

出版信息

J Gastroenterol. 2023 Dec;58(12):1261-1271. doi: 10.1007/s00535-023-02033-3. Epub 2023 Sep 7.

Abstract

BACKGROUND

This substudy of the Cancer-VTE Registry estimated venous thromboembolism (VTE) incidence and risk factors in pancreatic cancer patients.

METHODS

The Cancer-VTE Registry was an observational study that collected VTE data from patients with solid tumors across Japan. We measured baseline VTE prevalence, and at 1-year follow-up, the cumulative incidence of symptomatic and composite VTE (symptomatic VTE and incidental VTE requiring treatment), bleeding, cerebral infarction/transient ischemic attack (TIA)/systemic embolic event (SEE), and all-cause death.

RESULTS

Of 1006 pancreatic cancer patients, 86 (8.5%) had VTE at baseline, and seven (0.7%) had symptomatic VTE. Significant risk factors of baseline VTE were Eastern Cooperative Oncology Group performance status (ECOG PS) of 1, body mass index (BMI) ≥ 25 kg/m, history of VTE, D-dimer > 1.2 µg/mL, and hemoglobin < 10 g/dL. At 1-year follow-up, the cumulative incidence of events was higher for pancreatic cancer vs other cancers. Pancreatic cancer patients with VTE vs those without VTE had significantly higher incidences of bleeding, cerebral infarction/TIA/SEE, and all-cause death. No significant risk factors for composite VTE were identified.

CONCLUSIONS

The cumulative incidence of composite VTE during cancer treatment was higher in pancreatic cancer than in other cancer types. Some risk factors for VTE prevalence at cancer diagnosis were identified. Although VTE prevalence at cancer diagnosis did not predict the subsequent 1-year incidence of composite VTE, it was a significant predictor of other events such as all-cause death in pancreatic cancer patients.

TRIAL REGISTRATION

UMIN Clinical Trials Registry; UMIN000024942.

摘要

背景

本项癌症-静脉血栓栓塞症(VTE)登记处的子研究旨在评估胰腺癌患者的 VTE 发生率和相关风险因素。

方法

癌症-静脉血栓栓塞症登记处是一项观察性研究,收集了来自日本各地实体瘤患者的 VTE 数据。我们测量了基线 VTE 的患病率,以及在 1 年随访时,评估了症状性 VTE 和复合 VTE(症状性 VTE 和需要治疗的偶发性 VTE)、出血、脑梗死/短暂性脑缺血发作(TIA)/系统性栓塞事件(SEE)和全因死亡的累积发生率。

结果

在 1006 例胰腺癌患者中,86 例(8.5%)基线时存在 VTE,7 例(0.7%)存在症状性 VTE。基线 VTE 的显著危险因素包括东部肿瘤协作组体能状态(ECOG PS)评分 1 分、体重指数(BMI)≥25kg/m²、VTE 病史、D-二聚体>1.2μg/mL 和血红蛋白<10g/dL。在 1 年随访时,胰腺癌患者的事件累积发生率高于其他癌症类型。与无 VTE 的胰腺癌患者相比,有 VTE 的患者出血、脑梗死/TIA/SEE 和全因死亡的发生率明显更高。未发现复合 VTE 的明确发生风险因素。

结论

在癌症治疗期间,胰腺癌患者的复合 VTE 累积发生率高于其他癌症类型。确定了一些癌症诊断时 VTE 患病率的风险因素。尽管癌症诊断时的 VTE 患病率不能预测随后 1 年的复合 VTE 发生率,但它是胰腺癌患者全因死亡等其他事件的显著预测因素。

试验注册

UMIN 临床试验注册;UMIN000024942。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a41/10657787/a01ddbd098b2/535_2023_2033_Fig1_HTML.jpg

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