Primäre medikamentöse Thromboembolieprophylaxe bei ambulanten Patienten mit fortgeschrittenem Pankreaskarzinom unter Chemotherapie?

TY - JOUR

T1 - Primäre medikamentöse Thromboembolieprophylaxe bei ambulanten Patienten mit fortgeschrittenem Pankreaskarzinom unter Chemotherapie?

AU - Pelzer, U

AU - Sinn, M

AU - Stieler, J

AU - Riess, H

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2013/10

Y1 - 2013/10

N2 - BACKGROUND AND OBJECTIVE: The indication for medical venous thrombosis prophylaxis in ambulatory cancer patients is still under discussion. To provide more data on this topic we conducted an analysis in ambulatory patients with advanced pancreatic adenocarcinoma, reflecting a patient cohort at high risk of symptomatic venous thromboembolism (sVTE).PATIENTS AND METHODS: Data from 312 consecutively recruited patients of the CONKO-004 trial were analysed according to predefined parameters and additionally with respect to established scores. To focus on patients with highest risk of sVTE unvaried and multivariate analyses were conducted.RESULTS: The global analyses had educed a number needed to treat (NNT) by medical thrombosis prophylaxis of 12 patients to prevent one sVTE. The modified score model did not provide further clinical benefit. However, the regression model can identify single parameters with a trend to higher risk of sVTE or higher risk of severe bleeding. Most of the parameters do not have enough power to be significant, but they can support clinical decisions.CONCLUSION: These data suggest that medical thrombosis prophylaxis should be performed in patients with advanced pancreatic cancer at least for the initial 3 months of first line chemotherapy.

AB - BACKGROUND AND OBJECTIVE: The indication for medical venous thrombosis prophylaxis in ambulatory cancer patients is still under discussion. To provide more data on this topic we conducted an analysis in ambulatory patients with advanced pancreatic adenocarcinoma, reflecting a patient cohort at high risk of symptomatic venous thromboembolism (sVTE).PATIENTS AND METHODS: Data from 312 consecutively recruited patients of the CONKO-004 trial were analysed according to predefined parameters and additionally with respect to established scores. To focus on patients with highest risk of sVTE unvaried and multivariate analyses were conducted.RESULTS: The global analyses had educed a number needed to treat (NNT) by medical thrombosis prophylaxis of 12 patients to prevent one sVTE. The modified score model did not provide further clinical benefit. However, the regression model can identify single parameters with a trend to higher risk of sVTE or higher risk of severe bleeding. Most of the parameters do not have enough power to be significant, but they can support clinical decisions.CONCLUSION: These data suggest that medical thrombosis prophylaxis should be performed in patients with advanced pancreatic cancer at least for the initial 3 months of first line chemotherapy.

KW - Adenocarcinoma/blood

KW - Ambulatory Care

KW - Anticoagulants/administration & dosage

KW - Dalteparin/administration & dosage

KW - Dose-Response Relationship, Drug

KW - Enoxaparin/administration & dosage

KW - Hemorrhage/blood

KW - Humans

KW - Injections, Subcutaneous

KW - Pancreatic Neoplasms/blood

KW - Prospective Studies

KW - Randomized Controlled Trials as Topic

KW - Risk Factors

KW - Survival Rate

KW - Venous Thromboembolism/mortality

U2 - 10.1055/s-0033-1349608

DO - 10.1055/s-0033-1349608

M3 - SCORING: Zeitschriftenaufsatz

C2 - 24085361

VL - 138

SP - 2084

EP - 2088

JO - DEUT MED WOCHENSCHR

JF - DEUT MED WOCHENSCHR

SN - 0012-0472

IS - 41

ER -