2018
DOI: 10.1016/j.clcc.2017.12.001
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Visceral Thromboses in Pancreas Adenocarcinoma: Systematic Review

Abstract: Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It … Show more

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Cited by 13 publications
(6 citation statements)
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“…Screening for PVT is required as part of the current Barcelona Clinic Liver Cancer staging system as the prognosis for patients with HCC and PVT is much worse [8]. Meanwhile, the higher increase in trend of hospitalization in pancreatic adenocarcinomas for SVT-related malignancies is compatible with recent data, as published by Hicks et al [16] and Afzal et al [17], suggesting that SVT is not only a finding of more advanced stages of the disease but is in itself a predictor of mortality leading to more frequent admissions. The high incidence of such occurrence is explained by the pro-thrombotic and pro-angiogenic state associated with both malignancies that are necessary for tumor growth and metastasis.…”
Section: Discussionmentioning
confidence: 65%
“…Screening for PVT is required as part of the current Barcelona Clinic Liver Cancer staging system as the prognosis for patients with HCC and PVT is much worse [8]. Meanwhile, the higher increase in trend of hospitalization in pancreatic adenocarcinomas for SVT-related malignancies is compatible with recent data, as published by Hicks et al [16] and Afzal et al [17], suggesting that SVT is not only a finding of more advanced stages of the disease but is in itself a predictor of mortality leading to more frequent admissions. The high incidence of such occurrence is explained by the pro-thrombotic and pro-angiogenic state associated with both malignancies that are necessary for tumor growth and metastasis.…”
Section: Discussionmentioning
confidence: 65%
“…Thrombosis in gastric cancer, while rarely seen (1.2%), is similar to HCC in that the portal vein is usually affected [ 1 ]. Pancreatic cancers, while commonly pro-thrombotic, are more frequently associated with splenic, portal, or mesenteric thrombi rather than IVC [ 5 ]. Thus, IVC thrombus from gastric cancer is extremely rare.…”
Section: Discussionmentioning
confidence: 99%
“…With the advances of diagnostic imaging, VsT has become a well-defined entity that is commonly diagnosed in patients with pancreatic cancer [34]. VsT is undervalued when compared with PE or DVT, and, as a consequence, anticoagulation therapy, a safe therapeutic approach as long as bleeding risk is carefully assessed, is underutilized [34,35]. In our cohort VsT was asymptomatic in 21 of 26 patients and diagnosed by a CT scan, in the context of pancreatic cancer diagnosis, staging, or response evaluation.…”
Section: Discussionmentioning
confidence: 99%