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Review
. 2023 Jul 8;15(14):3546.
doi: 10.3390/cancers15143546.

Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care

R A L Willems  1   2   3   4   5 , N Michiels  6 , V R Lanting  7   8   9 , S Bouwense  10   11 , B L J van den Broek  12 , M Graus  4   13 , F A Klok  14 , B Groot Koerkamp  12 , B de Laat  1   5   15 , M Roest  15 , J W Wilmink  16   17 , N van Es  7   8 , J S D Mieog  6 , H Ten Cate  2   3   5 , J de Vos-Geelen  4   13
Affiliations
Review

Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care

R A L Willems et al. Cancers (Basel). .

Abstract

Recent studies have shown that patients with pancreatic ductal adenocarcinoma (PDAC) treated with neoadjuvant chemo(radio)therapy followed by surgery have an improved outcome compared to patients treated with upfront surgery. Hence, patients with PDAC are more and more frequently treated with chemotherapy in the neoadjuvant setting. PDAC patients are at a high risk of developing venous thromboembolism (VTE), which is associated with decreased survival rates. As patients with PDAC were historically offered immediate surgical resection, data on VTE incidence and associated preoperative risk factors are scarce. Current guidelines recommend primary prophylactic anticoagulation in selected groups of patients with advanced PDAC. However, recommendations for patients with (borderline) resectable PDAC treated with chemotherapy in the neoadjuvant setting are lacking. Nevertheless, the prevention of complications is crucial to maintain the best possible condition for surgery. This narrative review summarizes current literature on VTE incidence, associated risk factors, risk assessment tools, and primary thromboprophylaxis in PDAC patients treated with neoadjuvant chemo(radio)therapy.

Keywords: anticoagulation therapy; cancer-associated thrombosis; chemotherapy; neoadjuvant treatment; pancreatic ductal adenocarcinoma; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflict of interest.

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