Venous thromboembolism episodes cut survival in pancreatic ductal adenocarcinoma patients

Episodes of venous thromboembolism (VTE) occurring after pancreatic ductal adenocarcinoma (PDAC) appear to worsen outcomes, a new study has found.

Researchers enrolled 731 patients (median age, 69 years; 52.8 percent male) with newly diagnosed PDAC. VTE diagnoses were designated as the primary endpoint, defined as a composite of symptomatic distal or proximal deep-vein thrombosis (DVT), symptomatic or incidental proximal and distal pulmonary embolism (PE), catheter-related thrombosis (CRT), and symptomatic or incidental visceral venous thrombosis (VVT). Overall (OS) and progression-free (PFS) survival were set as secondary outcomes.

Over a median follow-up duration of 19.3 months, VTE events were reported in 152 participants, yielding an incidence ratio of 20.79 percent. Most (54.0 percent) were asymptomatic.

Stratifying according to the specific type of the event showed that there were 45 VVT events, 40 DVTs, 26 PEs and 32 combined events. VTE occurred within a median of 4.49 months after PDAC onset. Demographic characteristics and Eastern Cooperative Oncology Group scores were comparable between those who did and did not develop VTEs.

The cumulative probability of VTE onset was 8.07 percent at 3 months, 13.19 percent at 6 months, 19.21 percent at 12 months and 24.7 percent at 18 months.

VTE emerged as a significant predictor of shortened PFS (hazard ratio [HR], 1.74, 95 percent confidence interval [CI], 1.19–2.54; p=0.004) and OS (HR, 2.02, 95 percent CI, 1.57–2.60; p<0.001). Median PFS and OS were significantly shorter in patients who developed VTEs.