Department of Surgery, Translational Cancer Medicine Research Program, iCAN Digital Precision Cancer Medicine Flagship, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Cancer Med. 2024 Jul;13(14):e70014. doi: 10.1002/cam4.70014.
Pancreatic cancer (PC) is associated with a high risk of venous thromboembolic events (VTEs). We investigated the incidence of VTE before and after the diagnosis of PC and its association with overall survival.
We identified PC patients diagnosed in 2013-2016 from the Finnish Cancer Registry. Data on healthcare visits and death were collected, along with follow-up data through the end of 2020. We compared patients who underwent radical-intent surgery (RIS) to those who underwent palliative treatment (PT) alone.
We identified 4086 PC patients, of whom 343 (8.4%) underwent RIS and 3743 (91.6%) received PT. VTE incidence within 1 year before a PC diagnosis was higher in the PT (4.2%, n = 156) than in the RIS group (0.6%, n = 2; p < 0.001). The cumulative incidence of VTE at 12 and 24 months after a PC diagnosis was 6% (n = 21) and 9% (n = 31), respectively, within the RIS group, and 8% (n = 286) and 8% (n = 304) within the PT group. In the PT group, a VTE within 1 year before a PC diagnosis was independently associated with a worse survival {hazard ratio, HR 1.9 [95% confidence interval (CI) 1.6-2.2]}. In both groups, VTE after a PC diagnosis was associated with a worse survival [RIS group: HR 2.6 (95%CI 1.8-3.7) vs. PT group: HR 2.2 (95%CI 1.9-2.4)].
A VTE within 1 year before a PC diagnosis more often occurred among PT PC patients than among patients who underwent RIS. VTE might serve as a diagnostic clue to detect PC at an earlier stage.
胰腺癌（PC）与静脉血栓栓塞事件（VTE）的风险较高相关。我们研究了 PC 诊断前后 VTE 的发生率及其与总生存的关系。
我们从芬兰癌症登记处确定了 2013-2016 年期间诊断的 PC 患者。收集了医疗就诊和死亡数据，并通过 2020 年底的随访数据进行了随访。我们比较了接受根治性意向手术（RIS）的患者和仅接受姑息治疗（PT）的患者。
我们确定了 4086 名 PC 患者，其中 343 名（8.4%）接受了 RIS，3743 名（91.6%）接受了 PT。PT 组（4.2%，n=156）VTE 发生率高于 RIS 组（0.6%，n=2；p<0.001）。RIS 组在 PC 诊断后 12 个月和 24 个月时的 VTE 累积发生率分别为 6%（n=21）和 9%（n=31），PT 组分别为 8%（n=286）和 8%（n=304）。在 PT 组中，PC 诊断前 1 年内发生的 VTE 与生存状况较差独立相关（风险比，HR 1.9 [95%置信区间（CI）1.6-2.2]）。在两组中，PC 诊断后发生的 VTE 与生存状况较差相关[RIS 组：HR 2.6（95%CI 1.8-3.7）vs. PT 组：HR 2.2（95%CI 1.9-2.4）]。
PT 组 PC 患者在 PC 诊断前 1 年内发生 VTE 的情况比接受 RIS 的患者更为常见。VTE 可能是更早发现 PC 的诊断线索。
