Pancreatic Carcinoma, Thrombosis and Mean Platelet Volume: Single Center Experience from the Southeast Region of Turkey

  • Afsar, Cigdem Usul (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Gunaldi, Meral (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Kum, Pinar (Department of Cancer Record Unit, Bahcelievler Medical Park Hospital) ;
  • Sahin, Berksoy (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Erkisi, Melek (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Kara, Ismail Oguz (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Paydas, Semra (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Duman, Berna Bozkurt (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Ercolak, Vehbi (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Karaca, Feryal (Department of Radiation Oncology, Bahcelievler Medical Park Hospital) ;
  • Uyeturk, Ummugul (Department of Medical Oncology, Bahcelievler Medical Park Hospital) ;
  • Guner, Sebnem Izmir (Department of Hematology, Bahcelievler Medical Park Hospital)
  • Published : 2014.11.28


Background: The aim of this study was to investigate the general characteristics of patients with deep vein thrombosis (DVT) and pancreatic cancer as well as evaluate the relationship between mean platelet volume (MPV), DVT and survival. Materials and Methods: Seventy-seven patients with pancreatic cancer, who were admitted to Cukurova University Medical Faculty, Department of Medical Oncology, were enrolled in the study Results: The mean age was $59{\pm}20$. Forty-nine (63.6%) were men and 28 women (36.4%). Sixty-eight (88.3%) patients had adenocarcinoma and 9 (11.7%) had a malignant epithelial tumor. Thirty-six (46.7%) had liver metastasis at diagnosis. Twenty-six (33.8%) patients were alive, 20 (26%) were dead and in 31 (40.2%) the status was unknown. Only 14 (18.1%) patients had DVT. In 42 (54.5%) patients MPV values were normal, in 28 (36.4%) patients they were above normal, and in 7 (9.1%) patients they were below normal. There was no statistically significant difference between gender, tumour localization, chemotherapy and survival rates (p:0.56, p:0.11, p:0.21). There was no significant difference between DVT, gender, localisation, histological subtype, the presence of metastasis, stage and if the patient had been treated with chemotherapy (p:0.5, p:0.6, p:0.2, p:0.32, p:0.1, p:0.84). There was also no significant difference between MPV and DVT (p:0.57) but there was a significant difference between liver metastasis and DVT (p:0.02). Age, stage, the presence of metastasis and DVT were prognostic in pancreatic cancer patients. Conclusions: Cases of pancreatic cancer with liver metastasis should be studied more carefully as thrombosis is more common in these patients.


  1. Adess M, Eisner R, Nand S, Godwin J, Messmore HL Jr, Wehrmacher WH (2006). Thromboembolism in cancer patients: pathogenesis and treatment. Clin Appl Thromb Hemost, 12, 254-66.
  2. Al Diab AI (2010). Cancer-related venous thromboembolism: insight into underestimated risk factors. Hematol Oncol Stem Cell Ther, 3, 191-5.
  3. Aliustaoglu M, Bilici A, Seker M, et al (2010). The association of pre-treatment peripheral blood markers with survival in patients with pancreatic cancer. Hepatogastroenterology, 57, 640-5.
  4. Alkim H, Ayaz S, Sasmaz N, Oguz P, Sahin B (2012). Hemostatic abnormalities in cirrhosis and tumor-related portal vein thrombosis. Clin Appl Thromb Hemost, 18, 409-15.
  5. Barbier L, Turrini O, Sarran A, Delpero JR (2010). Pancreatic endocrine tumor with neoplastic venous thrombus and bilobar liver metastasis. A case report. J Visc Surg, 147, 58-62.
  6. Becouarn Y, Senesse P, Thezenas S, et al (2007). A randomized phase II trial evaluating safety and efficacy of an experimental chemotherapy regimen (irinotecan + oxaliplatin, IRINOX) and two standard arms (LV5 FU2 + irinotecan or LV5 FU2 + oxaliplatin) in first-line metastatic colorectal cancer: a study of the Digestive Group of the Federation Nationale des Centres de Lutte Contre le Cancer. Ann Oncol, 18, 2000-5.
  7. Biino G, Portas L, Murgia F, et al (2012). A population-based study of an Italian genetic isolate reveals that mean platelet volume is not a risk factor for thrombosis. Thromb Res, 129, 8-13.
  8. Braekkan SK, Mathiesen EB, Njolstad I, et al (2012). Mean platelet volume is a risk factor for venous thromboembolism: the tromso study. J Thromb Haemost, 8, 157-62.
  9. Burris HA, 3rd, Moore MJ, Andersen J, et al (1997). Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol, 15, 2403-13.
  10. Canan A, Halicioglu SS, Gurel S (2012). Mean platelet volume and D-dimer in patients with suspected deep venous thrombosis. J Thromb Thrombolysis, 34, 283-7.
  11. Canyilmaz E, Serdar L, Uslu GH, et al (2013). Evaluation of prognostic factors and survival results in pancreatic carcinomas in Turkey. Asian Pac J Cancer Prev, 14, 6573-8.
  12. Cheung R (2013). Racial and social economic factors impact on the cause specific survival of pancreatic cancer: a SEER survey. Asian Pac J Cancer Prev, 14, 159-63.
  13. Chew HK, Wun T, Harvey D, Zhou H, White RH (2006). Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med, 166, 458-64.
  14. Chu SG, Becker RC, Berger PB, et al (2012). Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost, 8, 148-56.
  15. Geer RJ, Brennan MF (1993). Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg, 165, 68.
  16. Habib M, Saif MW (2013). Thromboembolism and anticoagulation in pancreatic cancer. JOP, 14, 135-7.
  17. Heit JA, SilversteinMD, Mohr DN, et al (2000). Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med, 160, 809-15.
  18. Hutten BA, Prins MH, Gent M, et al (2000). Incidence of recurrent thromboembolic and bleeding complications among patients with thromboembolism in relation to both malignancy and achieved international normalized ratio: a retrospective analysis. J Clin Oncol, 18, 3078.
  19. Karaman K, Bostanci EB, Aksoy E, et al (2011). The predictive value of mean platelet volume in differential diagnosis of non-functional pancreatic neuroendocrine tumors from pancreatic adenocarcinomas. Eur J Intern Med, 22, 95-8.
  20. Kurt M, Onal IK, Sayilir AY, et al (2012). The role of mean platelet volume in the diagnosis of hepatocellular carcinoma in patients with chronic liver disease. Hepatogastroenterology, 59, 1580-2.
  21. Lee JC, J Ro YS, Hyejin C (2013). Venous thromboemboembolism in patients with pancreatic cancer: Incidence and effect on survival in east Asian ethnic groups. J Clin Oncol, 30, 151.
  22. Lip GY, Chin BS, Blann AD (2002). Cancer and the prothrombotic state. Lancet Oncol, 3, 27.
  23. Liu XM, Liu FH, Tang Y, Li Q (2012). MTHFR C677T polymorphism and pancreatic cancer risk: a meta-analysis. Asian Pac J Cancer Prev, 13, 3763-6.
  24. Mutlu H, Artis TA, Erden A, Akca Z (2012). Alteration in mean platelet volume and platicrit values in patients with cancer that developed thrombosis. Clin Appl Thromb Hemost, 19, 331-3.
  25. Norsa' adah B, Nur-Zafira A, Knight A (2012). Pancreatic cancer in Universiti Sains Malaysia Hospital: a retrospective review of years 2001-2008. Asian Pac J Cancer Prev, 13, 2857-60.
  26. Porta M, Fabregat X, Malats N, et al (2005). Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage. Clin Transl Oncol, 7, 189-97.
  27. Sgouros J, Maraveyas A (2008). Excess premature (3-month) mortality in advanced pancreatic cancer could be related to fatal vascular thromboembolic events. A hypothesis based on a systematic review of phase III chemotherapy studies in advanced pancreatic cancer. Acta Oncol, 47, 337-46.
  28. Shaib W, Denq Y, Zilterman D, Lundberq B, Saif MW (2010). Assessing risk and mortality of venous thromboembolism in pancreatic cancer patients. Anticancer Res, 30, 4261-4.
  29. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics, CA Cancer J Clin, 63, 11.
  30. Streiff MB (2011). Anticoagulation in the management of venous thromboembolism in the cancer patient. J Thromb Thrombolysis, 31, 282-94.
  31. Trede M, Schwall G, Saeger HD (1990). Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg, 211, 447.
  32. Zhang JF, Hua R, Sun YW, et al (2013). Influence of perineural invasion on survival and recurrence in patients with resected pancreatic cancer. Asian Pac J Cancer Prev, 14, 5133-9.

Cited by

  1. Can Head and Neck Cancers Be Detected with Mean Platelet Volume? vol.16, pp.16, 2015,
  2. Relationships Between C-Kit Expression and Mean Platelet Volume in Benign, Preneoplastic and Neoplastic Endometrium vol.16, pp.4, 2015,
  3. Increased UGT1A3 and UGT1A7 Expression is Associated with Pancreatic Cancer vol.16, pp.4, 2015,
  4. Thromboembolisms in Advanced Pancreatic Cancer vol.46, pp.8, 2017,
  5. Role of increased mean platelet volume (MPV) and decreased MPV/platelet count ratio as poor prognostic factors in lung cancer pp.17526981, 2017,
  6. Large platelet size is associated with poor outcome in patients with metastatic pancreatic cancer vol.0, pp.0, 2018,