Clinical Significance of Venous Thromboembolism in Patients with Advanced Cholangiocarcinoma

• Published in: Gut and liver Vol. 18; no. 1; pp. 165 - 173
• Main Authors: Kim, Joo Seong, Paik, Woo Hyun, Lee, Sang Hyub, Lee, Min Woo, Park, Namyoung, Choi, Jin Ho, Cho, In Rae, Ryu, Ji Kon, Kim, Yong-Tae
• Format: Journal Article
• Language: English
• Published: Korea (South) Editorial Office of Gut and Liver 01.01.2024; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: advanced stage; Bile Duct Neoplasms - complications; Bile Ducts, Intrahepatic; cholangiocarcinoma; Cholangiocarcinoma - complications; Clinical Relevance; Humans; Incidence; Original; prognostic factor; Retrospective Studies; Risk Factors; venous thromboembolism; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology; 내과학; Prognostic factor; Advanced stage; Cholangiocarcinoma; Venous thromboembolism
• ISSN: 1976-2283; 2005-1212; 2005-1212
• DOI: 10.5009/gnl220477

Patients with active cancer frequently develop venous thromboembolism (VTE). However, there is little data about VTE in patients with advanced cholangiocarcinoma (CCA). Therefore, we investigated the clinical significance of VTE in patients with advanced CCA. We analyzed the data of a total of 332 unresectable CCA patients diagnosed between 2010 and 2020 in this retrospective study. We investigated the incidence and risk factors for VTE, and its effect on survival in patients with advanced CCA. During a median follow-up of 11.6 months, 118 patients (35.5%) developed VTE. The cumulative incidence of VTE was 22.4% (95% confidence interval [CI], 0.18 to 0.27) at 3 months and 32.8% (95% CI, 0.27 to 0.38) at 12 months. Major vessel invasion was an independent risk factor for VTE (hazard ratio, 2.88; 95% CI, 1.92 to 4.31; p<0.001). Patients who developed VTE during follow-up had shorter overall survival than patients who did not (11.50 months vs 15.83 months, p=0.005). In multivariable analysis, VTE (hazard ratio, 1.58; 95% CI, 1.23 to 2.02; p<0.001) was associated with poor overall survival. Major vessel invasion is related to the occurrence of VTE in advanced CCA. The development of VTE significantly decreases the overall survival and is an important unfavorable prognostic factor for survival.