Venous thromboembolism and pancreatic cancer: incidence, pathogenesis and clinical implications

Pancreatic cancer is still a major clinical challenge. Recent efforts to improve survival in locally advanced and metastatic disease have focused on combining cytotoxic drugs with targeted therapies. One of the major complications of pancreatic cancer is venous thromboembolism (VTE). Despite the general perception that patients with mucinous carcinoma of the pancreas and gastrointestinal tract present a high incidence of thromboembolic complications, there is little data regarding the incidence and pathogenesis of VTE in pancreatic cancer patients. Clinical data suggest that, among patients with unresectable pancreatic cancer, the occurrence of VTE may be associated with reduced overall survival. Furthermore emerging clinical data strongly suggest that anticoagulant treatments may improve cancer patient survival by decreasing thromboembolic complications as well as by anticancer effects. Given the lack of extensive data and the clinical relevance of this topic for both physicians and basic research scientists, this overview focuses attention on the incidence, pathogenesis and clinical implications of VTE in pancreatic cancer patients.