The incidence and risk factors of venous thromboembolism in patients with pancreatic cancer: a systematic review and meta-analysis.

BACKGROUND

Venous thromboembolism (VTE) is a common complication of malignant tumors. The incidence of VTE in patients with pancreatic cancer (PC) may be higher than that in other patients, but varies significantly between studies. Therefore, we aimed to investigate the incidence and risk factors for VTE in patients with PC.

METHODS

We searched relevant studies from seven electronic databases from their inception to December 25, 2024. The incidence of VTE, odds ratio (OR), and 95% confidence interval (CI) were extracted to evaluate the incidence of VTE and its risk factors in PC patients. The robustness of the results was tested by sensitivity analysis. We used funnel plot and Egger test to assess publication bias.

RESULTS

A total of 61 articles were included in this study, including 29,921 patients. The incidence of VTE was 15.6%. Tumor location (OR =1.92; 95% CI: 1.25-2.94), poorly differentiated (OR =2.54; 95% CI: 1.53-4.23), tumor, node, metastasis (TNM) stage IV (OR =2.82; 95% CI: 1.12-7.08), metastasis (OR =2.16; 95% CI: 1.59-2.93) and higher D-dimer (OR =4.33; 95% CI: 1.26-14.86) were risk factors for VTE.

CONCLUSIONS

The incidence of VTE is high in patients with PC. The tumor located in the body or tail, poorly differentiated, stage IV cancer, distant metastasis, and increased D-dimer levels after surgery are risk factors for VTE. The limitations mainly include high heterogeneity. This indicates that such high-risk patients should be identified early in clinical work, and attention should be paid to the evaluation and intervention for VTE in patients with PC.