PO-05 - Incidence of venous thromboembolism (VTE) in bile duct tumors (BDT) treated with chemotherapy in ambulatory setting

Introduction The incidence of thrombosis associated with pancreatic cancer chemotherapy is high (22-36%), however the incidence in BDT is unknown. Table 1 . Clinical characteristics No VTE (n = 110) VTE (n = 26) Male 61 (55.5%) 15 (57.7%) Female 49 (44.5%) 11 (42.3%) Age, years Median (range) 64.5 (36.0-85.4) 64.3 (36.7-82.5) ECOG 0-1 75 (68.2%) 18 (69.2%) ECOG ≥ 2 21 (19.1%) 4 (15.4%) Unknown 14 (12.7%) 4 (15.4%) Central venous catheter  No 93 (84.5%) 19 (73.1%)  Yes 11 (10.0%) 4 (15.4%)  Unknown 6 (5.5%) 3 (11.5%) Previous ATE:  No 99 (90%) 24 (92.3%)  Yes 11 (10%) 2 (7.7%) Previous VTE:  No 107 (97.3%) 25 (96.2%)  Yes 3 (2.7%) 1 (3.8%) Tumor site:  Gallbladder 22 (20.0%) 4 (15.4%)  Intrahepatic bile duct 40 (36.4%) 13 (50%)  Perihilar bile duct 23 (20.9%) 6 (23.1%)  Distal extrahepatic bile duct 17 (15.4%) 1 (3.8%)  Unspecified/undetermined 8 (7.3%) 2 (7.7%) Stage  Localized 28 (25.5%) 5 (19.2%)  Locally advanced 32 (29.1%) 6 (23.1%)  Mestastatic 47 (42.7%) 15 (57.7%)  Unknown 3 (2.7%) 0 Khorana:  0-1 93 (84.5%) 21 (80.8%)  2 9 (8.2%) 2 (7.7%)   ≥ 3 1 (0.9%) 0  Unknown 7 (6.4%) 3 (11.5%) Aim The aim of this study is to analyze the incidence of incidental and symptomatic VTE, and its chronological pattern, in patients with BDT receiving chemotherapy in ambulatory setting. Materials and Methods We conducted a retrospective study to determine the incidence of VTE in patients with BDT, treated at 6 hospitals of the Cancer & Thrombosis Working Group of the Spanish Society of Medical Oncology (SEOM). 136 consecutive patients diagnosed and treated with chemotherapy, were identified between January 2008 and December 2012 and included in this analysis. Results Clinical characteristics in Table 1. With a median follow up of 16.6 months (range 0.4-98.2), VTE was identified in 26 patients (19.1%): 10 pulmonary embolism, 9 deep vein thrombosis and 7 visceral vein thrombosis. All VTE occurred in patients with active tumor (2 locally advanced, 24 metastatic). 46% of the events were incidentally diagnosed. 62% of the events occurred in the first 6 months after diagnosis of cancer. Eight events were identified during the diagnostic workup of the neoplasm. Only 1 patient had a VTE recurrence (superficial venous thrombosis). A non-significant trend towards lower survival (OS) in patients with VTE (median OS 20.9 months vs 13.6 months; p = 0.066) was observed. Conclusions The incidence of VTE in patients undergoing chemotherapy for BDT in the ambulatory setting is high, but lower than that described in pancreatic cancer.