Summary
This retrospective analysis aimed to identify whether low-molecular- weight heparins
(LMWH) might improve survival in patients receiving chemotherapeutic treatment for
advanced pancreatic adenocarcinoma.Two hundred forty-three patients who had received
chemotherapy for advanced pancreatic adenocarcinoma were identified from a prospectively
maintained database. Of these, 30 patients had to be excluded from analysis due to
insufficient documentation. Of the remaining 213 patients 94 patients had been treated
with LMWH, whereas 119 patients served as controls. Outcome was assessed in relation
to overall survival, which was calculated from the date of initiation of chemotherapy
to the date of death.There was no significant difference (hazard ratio, 0.8; 95% confidence
interval (CI), 0.6 to 1.1; P=0,2) between the two groups in terms of overall survival.
The median survival was 7.1 months (95% CI,5.8–8.4 months) in the LMWH group and 5.9
months (95% CI, 5.1–6.7 months) in the non-LMWH group. A positive effect of LMWH was
seen in patients with metastatic disease (hazard ratio for LMWH vs. non-LMWH, 0,6;
95% CI, 0,4 to 0,8; P=0,006) in contrast to those without metastatic disease (hazard
ratio for LMWH vs. non-LMWH, 1; 95% CI, 0.6 to 1.7; P=0,96).The median survival of
patients with metastatic disease was 6,6 months (95% CI, 5–8,2 months) and 3.8 months
(95% CI, 2.5–5.1 months) for the LMWH group and the non-LMWH group, respectively.
In conclusion, we found for metastatic pancreatic adenocarcinoma a survival advantage
for patients receiving LMWH. Nevertheless, our observations need confirmation by prospective
randomized studies.
Keywords
Low-molecular-weight heparin - pancreatic adenocarcinoma - metastasis - survival
