کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5621893 1579186 2017 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Full Length ArticleIncidence, outcome and risk stratification tools for venous thromboembolism in advanced pancreatic cancer - A retrospective cohort study
ترجمه فارسی عنوان
طول کامل مواد مورد نیاز، مواد و نتایج طبقه بندی ریسک و خطر برای ترومبوآمبولیون وریدی در سرطان پانکراس پیشرفته - یک مطالعه کوهورت گذشته نگر
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی


- The addition of aPTT ratio to CONKO or Khorana score may represent a novel tool to identify advanced pancreatic cancer patients at high risk for VTE
- Optimal management of cancer patients with incidentally diagnosed SVT is controversial. Our data suggests that survival of APC patients is not adversely affected by asymptomatic SVT.
- Safety of low molecular weight heparin (LMWH) use in APC patients is confirmed in a “real life” clinical setting.

IntroductionVenous thromboembolism (VTE) is frequent in advanced pancreatic cancer (APC). Recent studies demonstrated that the Khorana score - an established risk stratification tool for VTE in cancer - performs poorly in identifying pancreatic cancer patients at high risk for VTE.Materials and methodsWe performed a retrospective cohort study in order to define incidence, treatment and outcome of VTE as well as the performance of VTE risk stratification tools (Khorana score, CONKO score and aPTT ratio) in a “real life” clinical cohort of APC patients undergoing palliative chemotherapy.Results and conclusionsOne hundred and seventy-two eligible APC patients from our comprehensive cancer center were identified. VTE after start of palliative chemotherapy was diagnosed in 71 patients (41.3%). Most VTE events were asymptomatic (n = 50, 29.1%) with only 21 symptomatic events (12.2%). On multivariate analysis - including age, performance status and carbohydrate antigen 19-9 (CA 19-9) - symptomatic VTE was an independent risk factor for death (hazard ratio [HR]: 2.22, 95% CI: 1.05-2.60, p < 0.05). Khorana score, CONKO score and aPTT ratio alone were not able to predict the risk for symptomatic VTE. High risk patients could only be identified by using a combination of either Khorana or CONKO score with aPTT ratio (30% vs. 10% symptomatic VTE events in high vs. low risk patients, p < 0.05). The combination of Khorana or CONKO score with aPTT thus may represent a novel risk stratification tool for symptomatic VTE in APC and should further be validated within prospective clinical trials.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Thrombosis Research - Volume 157, September 2017, Pages 9-15
نویسندگان
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