Sir Yue-kong Pao Centre for Cancer, Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Medicine, United Christian Hospital, Hong Kong SAR, China.
Hong Kong Med J. 2023 Oct;29(5):396-403. doi: 10.12809/hkmj219788. Epub 2023 Oct 4.
Patients with pancreatic cancer have a high risk of thromboembolism (TE), which may increase mortality. Most relevant studies have been conducted in Western populations. We investigated risk factors for TE in a predominantly Chinese population of patients with pancreatic cancer, along with effects of TE on overall survival.
This retrospective cohort study included patients diagnosed with exocrine pancreatic cancer in Prince of Wales Hospital in Hong Kong between 2010 and 2015. Data regarding patient demographics, World Health Organization performance status, stage, treatment, TE-related information, and time of death (if applicable) were retrieved from electronic medical records. Univariate and multivariable logistic regression analyses were performed to identify risk factors for TE. Survival analyses were performed using Kaplan-Meier analysis and Cox proportional hazards regression.
In total, 365 patients were included in the study. The overall incidence of TE (14.8%) was lower than in Western populations. In univariate logistic regression analysis, stage IV disease and non-head pancreatic cancer were significantly associated with TE (both P=0.01). Multivariable logistic regression analysis showed that stage IV disease was a significant risk factor (odds ratio=1.08, 95% confidence interval [CI]=1.00-1.17; P=0.046). Median overall survival did not significantly differ between patients with and without TE (4.88 months vs 7.80 months, hazard ratio=1.08, 95% CI=0.80-1.49; P=0.58) and between patients with TE who received anticoagulation treatment or not (5.63 months vs 4.77 months, hazard ratio=0.72, 95% CI=0.40-1.29; P=0.27).
The incidence of TE was low in our Chinese cohort. Stage IV disease increased the risk of TE. Overall survival was not affected by TE or its treatment.
胰腺癌患者有发生血栓栓塞（TE）的高风险，这可能会增加死亡率。大多数相关研究都是在西方人群中进行的。我们调查了以中国人为主的胰腺癌患者中 TE 的风险因素，以及 TE 对总生存的影响。
本回顾性队列研究纳入了 2010 年至 2015 年期间在香港威尔士亲王医院诊断为胰腺外分泌癌的患者。从电子病历中检索了患者的人口统计学、世界卫生组织表现状态、分期、治疗、TE 相关信息以及死亡时间（如适用）等数据。采用单变量和多变量逻辑回归分析来确定 TE 的风险因素。采用 Kaplan-Meier 分析和 Cox 比例风险回归进行生存分析。
共纳入 365 例患者。TE 的总体发生率（14.8%）低于西方人群。在单变量逻辑回归分析中，IV 期疾病和非头部胰腺癌与 TE 显著相关（均 P=0.01）。多变量逻辑回归分析显示，IV 期疾病是一个显著的危险因素（比值比=1.08，95%置信区间[CI]为 1.00-1.17；P=0.046）。有 TE 和无 TE 的患者的中位总生存期无显著差异（4.88 个月 vs 7.80 个月，风险比=1.08，95%CI=0.80-1.49；P=0.58），以及接受抗凝治疗和未接受抗凝治疗的 TE 患者的中位总生存期也无显著差异（5.63 个月 vs 4.77 个月，风险比=0.72，95%CI=0.40-1.29；P=0.27）。
我们的中国队列中 TE 的发生率较低。IV 期疾病增加了 TE 的风险。TE 或其治疗对总生存没有影响。
