Research and practice in thrombosis and haemostasis · 2026
Venous thromboembolism following surgery for pancreatic neuroendocrine neoplasms.
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Dong Kelly, Essaji Yasmin, Hicks Caitlin W, Haut Elliott R, Mavros Michail N
Аннотация
BACKGROUND: Pancreatic neuroendocrine neoplasms (pNENs) are rare and clinically heterogeneous tumors with a growing incidence. Given the thrombotic risk associated with malignancy and major surgery, understanding the postoperative venous thromboembolism (VTE) in this population is essential for guiding prophylactic strategies.
OBJECTIVES: The primary objectives were to determine the risk of postoperative VTE after pancreatectomy in patients with pNEN versus other histologies and to identify VTE risk factors in patients with pNEN.
METHODS: The Pancreatectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program from 2014 to 2022 was used to compare 30-day postoperative VTE frequency following pancreatectomy for pNEN versus other pancreatic histologies. Multivariable logistic regression models were used to assess the association between tumor histology and VTE. We identified VTE risk factors with subgroup analyses of patients with pNEN.
RESULTS: Among 60,649 eligible patients, 2135 (3.5%) patients developed VTE postoperatively. Of 7572 patients undergoing surgery for pNEN, 270 (3.6%) developed VTE with no difference in postoperative VTE frequency based on histology (3.6% in pNEN vs 3.5% in non-pNEN). On multivariable analysis, pNEN histology compared with pancreatic adenocarcinoma was not associated with increased risk of VTE (adjusted odds ratio [OR], 1.16; 95% CI, 0.97-1.37) or pulmonary embolism (OR, 1.14; 95% CI, 0.88-1.49); however, these patients had higher adjusted risk of deep venous thrombosis (OR, 1.25; 95% CI, 1.02-1.52). In patients with pNEN, variables independently associated with VTE included higher body mass index, preoperative transfusion, longer operative time, total pancreatectomy, and longer hospitalization.
CONCLUSION: While patients with pNEN undergoing pancreatectomy experience postoperative VTE at frequencies comparable with other pancreatic histologies, we observed a higher risk for deep venous thrombosis. We identified risk factors for postoperative VTE in patients with pNEN, which informs decisions on perioperative thromboprophylaxis.
OBJECTIVES: The primary objectives were to determine the risk of postoperative VTE after pancreatectomy in patients with pNEN versus other histologies and to identify VTE risk factors in patients with pNEN.
METHODS: The Pancreatectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program from 2014 to 2022 was used to compare 30-day postoperative VTE frequency following pancreatectomy for pNEN versus other pancreatic histologies. Multivariable logistic regression models were used to assess the association between tumor histology and VTE. We identified VTE risk factors with subgroup analyses of patients with pNEN.
RESULTS: Among 60,649 eligible patients, 2135 (3.5%) patients developed VTE postoperatively. Of 7572 patients undergoing surgery for pNEN, 270 (3.6%) developed VTE with no difference in postoperative VTE frequency based on histology (3.6% in pNEN vs 3.5% in non-pNEN). On multivariable analysis, pNEN histology compared with pancreatic adenocarcinoma was not associated with increased risk of VTE (adjusted odds ratio [OR], 1.16; 95% CI, 0.97-1.37) or pulmonary embolism (OR, 1.14; 95% CI, 0.88-1.49); however, these patients had higher adjusted risk of deep venous thrombosis (OR, 1.25; 95% CI, 1.02-1.52). In patients with pNEN, variables independently associated with VTE included higher body mass index, preoperative transfusion, longer operative time, total pancreatectomy, and longer hospitalization.
CONCLUSION: While patients with pNEN undergoing pancreatectomy experience postoperative VTE at frequencies comparable with other pancreatic histologies, we observed a higher risk for deep venous thrombosis. We identified risk factors for postoperative VTE in patients with pNEN, which informs decisions on perioperative thromboprophylaxis.