scholarly journals Incidence, Risk Factors, and Outcomes of Arterial Thromboembolism in Patients with Pancreatic Cancer Following Palliative Chemotherapy

Cancers ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 432
Author(s):  
Yu-Shin Hung ◽  
Jen-Shi Chen ◽  
Yen-Yang Chen ◽  
Chang-Hsien Lu ◽  
Pei-Hung Chang ◽  
...  

Background: Few studies have explored the association between pancreatic cancer and arterial thromboembolism (aTE). Methods: A total of 838 consecutive patients receiving palliative chemotherapy for pancreatic cancer between 2010 and 2016 were retrospectively enrolled. The clinical characteristics of patients were analyzed to determine the incidence, risk factors, and survival outcome of aTE in patients with pancreatic cancer. Results: aTE occurred in 42 (5.0%) of 838 patients. Patients with aTE had a worse survival outcome than those without (5.1 months versus 7.8 months, hazard ratio 1.53, 95% confidence interval [CI]: 1.12–2.09). Stage IV disease, high aspartate transaminase level, and comorbidity with hypertension or atrial fibrillation were four independent predictors of aTE. A concise predictive model stratified patients into low (0–1 predictor), intermediate (2 predictors), and high (3–4 predictors) risk groups. The hazard ratios for the comparison of patients in intermediate and high risk groups with those in low risk group were 4.55 (95% CI: 2.31–8.98), and 13.3 (95% CI: 5.63–31.6), respectively. Conclusion: Patients with pancreatic cancer undergoing palliative chemotherapy have an increased risk of aTE. A predictive model showed that patients presented with 3 or 4 predictors had the highest risk for developing aTE.

2019 ◽  
Vol 8 (9) ◽  
pp. 1402 ◽  
Author(s):  
Liu ◽  
Hung ◽  
Hsueh ◽  
Chang ◽  
Chen ◽  
...  

The aim of this study was to evaluate the prevalence, the clinicopathological variables associated with probability of lung metastases, and the impact of lung metastases on survival outcome in patients with stage IV pancreatic cancer (PC) treated with palliative chemotherapy. A total of 654 patients with stage IV PC who underwent palliative chemotherapy from 2010–2016 were retrospectively enrolled in this study. Possible clinical variables associated with lung metastases and survival outcome were examined by univariate and multivariate analysis. Lung metastases were detected in 15.0% (3.4% with isolated lung metastases and 11.6% with synchronic metastases to lung and other organs). Female gender, poorly differentiated tumor grade, and large primary tumor size were independent risk factor in multivariate analysis. The median overall survival (OS) time was 6.5 months in the entire cohort, while the median OS was 11.8, 6.9, 7.7, 10.1, and 5.0 months for patients with isolated lung, isolated liver, isolated peritoneum, isolated distant lymph nodes, and multiple sites metastases, respectively. Isolated lung metastases were a better prognosticator for OS in univariate and multivariate analysis. This study utilized real-world clinical practice data to assess the prevalence, risk factors, and survival impact of lung metastases in patients with stage IV pancreatic cancer.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15066-e15066
Author(s):  
Younak Choi ◽  
Do-Youn Oh ◽  
Tae-Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
...  

e15066 Background: The obesity is increasing worldwide. High body mass index (BMI) is linked with an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those are receiving palliative chemotherapy (the majority of all PC patients), the impact of BMI and its change during disease course on survival has not been fully investigated. Methods: Consecutive patients with APC were enrolled during years 2003-2010, all treated with palliative chemotherapy. The BMI measured at the point of starting the first cycle of palliative chemotherapy was called as “BMI at diagnosis”. “Pre-cancer weight” which means the weight in good health was the sum of “weight at diagnosis” and “weight loss at diagnosis” that the patients’ self- reported at the first visit. “Pre-cancer BMI” was calculated using pre-cancer weight. We got weight data measured at every visit during chemotherapy to investigate BMI change during chemotherapy period. Clinical characteristics and outcomes were analyzed. Results: A total of 425 patients were enrolled (median age, 60.1 years). At diagnosis of APC, the BMI distribution of patients was as follows: <18.5 (45, 10.6%); 18.5-19.9 (67, 15.8%); 20.0-22.4 (156, 36.7%); 22.5-24.9 (107, 25.2%); 25.0-29.9 (49, 11.5%); and ≥30.0 (1, 0.2%). Clinical characteristics were balanced across BMI groups. Median overall survival (OS) was 8.1 months (95% CI, 7.2-9.1). Pre-cancer BMI and BMI at diagnosis had no impact on OS (p = 0.488, p = 0.348, respectively), although patients at BMI range of 22.5-24.9 achieved the longest OS (9.9 months; 95% CI, 8.5-11.3). BMI loss at diagnosis (pre-cancer BMI minus BMI at the diagnosis) and BMI loss during chemotherapy (both stipulated as BMI change ≥1) were associated with shortened OS (HR, 1.300; p = 0.012 and HR, 1.367; p= 0.010, respectively). Conclusions: In patients with APC undergoing palliative chemotherapy, both declines in BMI at diagnosis of APC and during chemotherapy are more hazardous for OS than pre-cancer BMI or BMI at diagnosis itself as absolute values. Further research evaluating strategies to maintain BMI during chemotherapy in this setting is thus warranted.


HPB ◽  
2017 ◽  
Vol 19 ◽  
pp. S55
Author(s):  
P. Martinez Quinones ◽  
A. Talukder ◽  
N. Walsh ◽  
A. Lawson ◽  
A. Jones ◽  
...  

2004 ◽  
Vol 8 (5) ◽  
pp. 303-309 ◽  
Author(s):  
Anatoli Freiman ◽  
John Yu ◽  
Antoine Loutfi ◽  
Beatrice Wang

Background: Malignant melanoma is a significant cause of morbidity and mortality worldwide. Sun-awareness campaigns increase public knowledge but may not translate into behavioral changes in practice, which is particularly alarming when reported for individuals in high-risk groups. In particular, patients diagnosed with melanoma are at increased risk of developing subsequent primary melanomas compared with the general population. Objectives: The study was undertaken (1) to assess whether patients with known risk factors for developing melanoma had been exposed to preventative campaign messages prior to their diagnosis, (2) to quantify whether the diagnosis of melanoma changed sun-related attitudes and behavior, and (3) to assess the adequacy of sun-related advice given to patients with melanoma, as well as their compliance with the advice. Methods: Using an anonymous questionnaire, 217 patients previously diagnosed with melanoma were interviewed on the source and frequency of received sun-related advice, as well as on their knowledge, attitudes, and behavior toward sun protection before and after the diagnosis. Results: The number of patients who reported receiving sun-related advice after being diagnosed with melanoma increased by 36% (52% pre-vs. 88% postDiagnosis), with advice being given more frequently and more often by a physician (19% pre- vs. 49% postdiagnosis). Furthermore, sun-related attitudes and behavioral practices were positively altered. Yet, patients with known risk factors were not preferentially targeted for advice before their diagnosis. Conclusions: The diagnosis of melanoma leads to increased sunwareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.


2010 ◽  
Vol 8 (10) ◽  
pp. 2105-2112 ◽  
Author(s):  
M. J. ENGBERS ◽  
A. VAN HYLCKAMA VLIEG ◽  
F. R. ROSENDAAL

Author(s):  
P Bachkangi ◽  
AH Taylor ◽  
JC Konje

Preterm birth (PTB) affects 9.6% of pregnancies worldwide and is associated with a very high perinatal mortality that depends on the gestational age at delivery. As a result, PTB has a significant health and financial impact on health systems, families and societies. Its aetiology is not fully understood, but in most cases it is multifactorial, with several maternal, paternal, and epidemiological factors associated with increased risk. Other factors include parental ethnicity, maternal age and body mass index, socioeconomic status, and where the families live. This review examines the influence of ethnicity as an individual risk factor for PTB. It also explores its influence on the epidemiology of PTB and demonstrates that data on certain ethnicities are lacking, despite the fact that these ethnic clusters are within the very ‘high-risk groups’ that are adequately represented in some Western societies. This review examines the influence of ethnicity as an individual risk factor for PTB and also explores its influence on the different epidemiological aspects. A thorough revisit of the ethnic epidemiology unveiled other unnoticed risk factors that if addressed appropriately prematurity can be prevented. Moreover, certain ethnicities were not within the attention of researchers, despite the facts that they are very ‘high-risk groups’ and are also adequately represented in some Western societies.


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