Thrombotic risk in gastroenteropancreatic neuroendocrine tumor patients: a single-center experience

Authors Sara Massironi, Federica Cavalcoli, Andrea Artoni, Valentina Sciola, Alessandra Zilli, Clorinda Ciafardini, Roberta Elisa Rossi.


Background Only scanty specific studies are available on venous thromboembolism (VTE) in neuroendocrine neoplasms (NEN). We retrospectively assessed the incidence of VTE in gastroenteropancreatic (GEP) NEN patients.

Methods Between 2000 and 2016, GEP-NEN patients were retrospectively evaluated for VTE. Major thrombotic  events included deep venous thrombosis (DVT) and pulmonary embolism (PE). 160 patients were included. The primary tumor site was: the gut in 99, pancreas in 54, and unknown in 7. A total of 93 patients had grade (G) 1 tumor, 36 G2, 4 G3; G was not available in 27 patients. TNM stage was I in 76 patients, II in 17, III in 23, and IV in 44.

Results Twelve patients developed VTE: 9 had DVT and 3 PE. The primary site of the tumor was located in the pancreas in 9 patients, in the gut in 2, and it was unknown in one patient. Two patients had a functioning tumor. Grading was G1 in 3 patients, G2 in 6, G3 in 2 cases, and not available in one. The TNM stage was IV in 5 patients, III in 2, II in 3, and I in 2. Two patients died during the study period, one of whom died from PE.

Conclusion GEP-NEN patients harbor a considerable risk of VTE, particularly high for pancreatic NEN patients, for patients with moderate-poorly differentiated neoplasms, and at an advanced tumor stage.

Keywords Gastroenteropancreatic neuroendocrine neoplasms, gastrointestinal tumors, thromboembolic complication, thromboembolism, paraneoplastic syndromes

Ann Gastroenterol 2021; 34 (4): 588-593

Original Articles