{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T03:45:39Z","timestamp":1784346339104,"version":"3.55.0"},"reference-count":103,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Pancreatic cancer (PC) is a highly lethal malignancy linked to the highest rate of thromboembolic complications (TEC) among all solid tumors. TECs occur in approximately 5\u201340% of PC patients. The most common type of TEC in PC is venous thromboembolism (VTE). The mechanisms leading to frequent TEC in PC are complex and involve interactions between tumor-derived procoagulant factors and the prothrombotic tumor microenvironment (TME). Secretion of tissue factor and proinflammatory cytokines by tumor cells and the TME, overexpression of heparanase and podoplanin, impaired fibrynolysis and increased neutrophil extracellular trap formation lead to platelet hyperactivation resulting in hypercoagulability in PC. Understanding these mechanisms is crucial for identifying risk factors of TEC. Current thromboembolism risk models have limited predictive accuracy, which reduces their clinical usefulness. Identifying patients with thromboembolism is challenging because these events are often asymptomatic and their clinical presentation varies depending on the location of the thrombus. Treatment of VTE in PC depends on the phase of the VTE; in the acute phase, treatment primarily involves LMWH. For long-term management, LMWH may be replaced by direct oral anticoagulants such as apixaban, edoxaban, or rivaroxaban. In cases of VTE recurrence, increasing the LMWH dose, switching to an oral anticoagulant, or placing an inferior vena cava filter should be considered. LWMH and unfractionated heparin (UFH) are preferred options for VTE prophylaxis. Novel therapies, including factor XI inhibitors, show efficacy comparable to LMWH while offering a better safety profile.<\/jats:p>","DOI":"10.3390\/cancers18060890","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T09:55:38Z","timestamp":1773136538000},"page":"890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From Physiology to Clinical Practice in Pancreatic Cancer-Related Thromboembolism\u2014A Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4752-2572","authenticated-orcid":false,"given":"Monika","family":"Jarowicz","sequence":"first","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Seku\u0142a","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiktor","family":"Kociemba","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0943-5991","authenticated-orcid":false,"given":"Katarzyna","family":"Polak","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Tacza\u0142a","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1122-6445","authenticated-orcid":false,"given":"Kamila","family":"Krupa","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Miski","sequence":"additional","affiliation":[{"name":"Students\u2019 Scientific Organization of Cancer Cell Biology, Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-2875","authenticated-orcid":false,"given":"Marta","family":"Fudalej","sequence":"additional","affiliation":[{"name":"Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"},{"name":"Department of Oncology, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-2043","authenticated-orcid":false,"given":"Andrzej","family":"Depta\u0142a","sequence":"additional","affiliation":[{"name":"Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Badowska-Kozakiewicz","sequence":"additional","affiliation":[{"name":"Department of Oncology Propaedeutics, Medical University of Warsaw, 01-445 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"ref_1","first-page":"12","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Li, X., Zhang, Y., Yan, Z., Jiang, W., and Rui, S. (2025). Global, regional and national burden of pancreatic cancer and its attributable risk factors from 2019 to 2021, with projection to 2044. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1521788"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1053\/j.gastro.2020.10.007","article-title":"Worldwide Burden of, Risk Factors for, and Trends in Pancreatic Cancer","volume":"160","author":"Huang","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1053\/j.gastro.2019.12.009","article-title":"Incidence of Venous Thromboembolism in Patients with Newly Diagnosed Pancreatic Cancer and Factors Associated with Outcomes","volume":"158","author":"Frere","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Prouse, T., Mohammad, M.A., Ghosh, S., Kumar, N., Duhaylungsod, M.L., Majumder, R., and Majumder, S. (2024). Pancreatic Cancer and Venous Thromboembolism. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25115661"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.ejca.2012.10.021","article-title":"Incidence of venous thromboembolism in patients with cancer\u2014A cohort study using linked United Kingdom databases","volume":"49","author":"Walker","year":"2013","journal-title":"Eur. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.3748\/wjg.v27.i19.2325","article-title":"Burden of venous thromboembolism in patients with pancreatic cancer","volume":"27","author":"Frere","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_8","first-page":"246","article-title":"Maladie Thromboembolique Veineuse et Cancer du Pancr\u00e9as. Venous thromboembolism and pancreatic cancer","volume":"43","author":"Bournet","year":"2018","journal-title":"J. Med. Vasc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/s00535-023-02033-3","article-title":"Incidence and risk factors for venous thromboembolism in the Cancer-VTE Registry pancreatic cancer subcohort","volume":"58","author":"Okusaka","year":"2023","journal-title":"J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S1470-2045(04)01606-7","article-title":"Pancreatic cancer and thromboembolic disease","volume":"5","author":"Khorana","year":"2004","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1160\/TH10-12-0789","article-title":"Symptomatic and incidental thromboembolism are both associated with mortality in pancreatic cancer","volume":"106","author":"Menapace","year":"2011","journal-title":"Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1160\/TH16-08-0615","article-title":"Cancer-associated venous thromboembolism: Burden, mechanisms, and management","volume":"117","author":"Ay","year":"2017","journal-title":"Thromb. Haemost."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.ccr.2011.09.009","article-title":"Direct signaling between platelets and cancer cells induces an epithelial-mesenchymal-like transition and promotes metastasis","volume":"20","author":"Labelle","year":"2011","journal-title":"Cancer Cell"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yamai, T., Ikezawa, K., Hiraga, E., Kawamoto, Y., Hirao, T., Higashi, S., Daiku, K., Maeda, S., Abe, Y., and Urabe, M. (2022). Early detection of venous thromboembolism after the initiation of chemotherapy predicts a poor prognosis in patients with unresectable metastatic pancreatic cancer who underwent first-line chemotherapy with gemcitabine plus nab-paclitaxel. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0264653"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.ejim.2022.07.020","article-title":"Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic carcinoma and treated with chemotherapy on an outpatient basis","volume":"105","author":"Olmos","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/ijc.20657","article-title":"Microvesicles derived from activated platelets induce metastasis and angiogenesis in lung cancer","volume":"113","author":"Wysoczynski","year":"2005","journal-title":"Int. J. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1055\/s-0037-1615384","article-title":"Tissue Factor Expression and Metastatic Potential of Colorectal Cancer","volume":"80","author":"Wada","year":"1998","journal-title":"Thromb. Haemost."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1002\/bjs.1800820831","article-title":"Tissue factor expression correlates with histological grade in human pancreatic cancer","volume":"82","author":"Kakkar","year":"1995","journal-title":"Br. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Elgundi, Z., Papanicolaou, M., Major, G., Cox, T.R., Melrose, J., Whitelock, J.M., and Farrugia, B.L. (2020). Cancer Metastasis: The Role of the Extracellular Matrix and the Heparan Sulfate Proteoglycan Perlecan. Front. Oncol., 9.","DOI":"10.3389\/fonc.2019.01482"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/s41568-020-00329-7","article-title":"The matrix in cancer","volume":"21","author":"Cox","year":"2021","journal-title":"Nat. Rev. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mitsis, M., Drosou, P., Tatsis, V., and Markopoulos, G.S. (2022). Neutrophil Extracellular Traps and Pancreatic Cancer Development: A Vicious Cycle. Cancers, 14.","DOI":"10.3390\/cancers14143339"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101346","DOI":"10.1016\/j.beha.2022.101346","article-title":"Mechanisms of thrombosis in pancreatic ductal adenocarcinoma","volume":"35","author":"Campello","year":"2022","journal-title":"Best Pract. Res. Clin. Haematol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1055\/s-0037-1616744","article-title":"Localization of Blood Coagulation Factors In Situ in Pancreatic Carcinoma","volume":"86","author":"Rucinska","year":"2001","journal-title":"Thromb. Haemost."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4834","DOI":"10.1200\/JCO.2009.22.6324","article-title":"Role of Tissue Factor in Cancer","volume":"27","author":"Kasthuri","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"215983","DOI":"10.1016\/j.canlet.2022.215983","article-title":"Tissue factor-induced fibrinogenesis mediates cancer cell clustering and multiclonal peritoneal metastasis","volume":"553","author":"Miyazaki","year":"2022","journal-title":"Cancer Lett."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1038\/s41416-022-01968-3","article-title":"Tissue factor in cancer-associated thromboembolism: Possible mechanisms and clinical applications","volume":"127","author":"Koizume","year":"2022","journal-title":"Br. J. Cancer"},{"key":"ref_27","first-page":"e1699","article-title":"Systematic study of tissue factor expression in solid tumors","volume":"6","author":"Harris","year":"2023","journal-title":"Cancer Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1055\/s-0038-1642709","article-title":"Tissue Factor Expression in Human Leukocytes and Tumor Cells","volume":"74","author":"Rickels","year":"1995","journal-title":"Thromb. Haemost."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1038\/sj.bjc.6690073","article-title":"Expression of tissue factor in non-small-cell lung cancers and its relationship to metastasis","volume":"79","author":"Sawada","year":"1999","journal-title":"Br. J. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Hisada, Y., and Mackman, N. (2021). Tissue Factor and Extracellular Vesicles: Activation of Coagulation and Impact on Survival in Cancer. Cancers, 13.","DOI":"10.3390\/cancers13153839"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1055\/s-0039-1687894","article-title":"Tissue Factor and Cancer: Regulation, Tumor Growth, and Metastasis","volume":"45","author":"Hisada","year":"2019","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1172\/JCI117451","article-title":"Tissue factor controls the balance of angiogenic and antiangiogenic properties of tumor cells in mice","volume":"94","author":"Zhang","year":"1994","journal-title":"J. Clin. Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4679","DOI":"10.1111\/cas.15106","article-title":"Tissue factor and its procoagulant activity on cancer-associated thromboembolism in pancreatic cancer","volume":"112","author":"Kobayashi","year":"2021","journal-title":"Cancer Sci."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Mayfosh, A.J., Nguyen, T.K., and Hulett, M.D. (2021). The Heparanase Regulatory Network in Health and Disease. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222011096"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/978-3-030-34521-1_3","article-title":"Heparanase: Historical Aspects and Future Perspectives","volume":"1221","author":"Khanna","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/s41416-019-0510-x","article-title":"The relationship between pancreatic cancer and hypercoagulability: A comprehensive review on epidemiological and biological issues","volume":"121","author":"Campello","year":"2019","journal-title":"Br. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Abecassis, A., Hermano, E., Yifrach, A., Popovtzer, A., Meirovitz, A., and Elkin, M. (2023). Heparanase contributes to pancreatic carcinoma progression through insulin-dependent glucose uptake. Front. Cell Dev. Biol., 11.","DOI":"10.3389\/fcell.2023.1287084"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1055\/s-0039-1688495","article-title":"Fibrin and Fibrinolysis in Cancer","volume":"45","author":"Kwaan","year":"2019","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2884","DOI":"10.1002\/1097-0142(19920615)69:12<2884::AID-CNCR2820691204>3.0.CO;2-S","article-title":"Peaks in plasma plasminogen activator inhibitor-1 concentration may explain thrombotic events in cases of pancreatic carcinoma","volume":"69","author":"Lecander","year":"1992","journal-title":"Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1002\/ijc.29837","article-title":"The origin and concentration of circulating microparticles differ according to cancer type and evolution: A prospective single-center study","volume":"138","author":"Mege","year":"2016","journal-title":"Int. J. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1038\/nri.2017.105","article-title":"Neutrophil extracellular traps in immunity and disease","volume":"18","author":"Papayannopoulos","year":"2018","journal-title":"Nat. Rev. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/cas.13580","article-title":"Podoplanin: An emerging cancer biomarker and therapeutic target","volume":"109","author":"Krishnan","year":"2018","journal-title":"Cancer Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/1476-4598-12-168","article-title":"Podoplanin expression in cancer-associated fibroblasts enhances tumor progression of invasive ductal carcinoma of the pancreas","volume":"12","author":"Shindo","year":"2013","journal-title":"Mol. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.thromres.2018.01.020","article-title":"The role of podoplanin in cancer-associated thrombosis","volume":"164","author":"Nazari","year":"2018","journal-title":"Thromb. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Oto, J., Navarro, S., Larsen, A.C., Solmoirago, M.J., Plana, E., Herv\u00e1s, D., Fern\u00e1ndez-Pardo, A., Espa\u00f1a, F., Kristensen, S.R., and Thorlacius-Ussing, O. (2020). MicroRNAs and Neutrophil Activation Markers Predict Venous Thrombosis in Pancreatic Ductal Adenocarcinoma and Distal Extrahepatic Cholangiocarcinoma. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21030840"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/nrc1256","article-title":"Tumour-educated macrophages promote tumour progression and metastasis","volume":"4","author":"Pollard","year":"2004","journal-title":"Nat. Rev. Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/MPA.0b013e3182546e13","article-title":"An Exploratory Study of Inflammatory Cytokines as Prognostic Biomarkers in Patients with Ductal Pancreatic Adenocarcinoma","volume":"41","author":"Dima","year":"2012","journal-title":"Pancreas"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/j.1349-7006.2008.00740.x","article-title":"Interleukin-8 increases vascular endothelial growth factor and neuropilin expression and stimulates ERK activation in human pancreatic cancer","volume":"99","author":"Li","year":"2008","journal-title":"Cancer Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3109\/14756366.2016.1161620","article-title":"Matrix metalloproteinases (MMPs), the main extracellular matrix (ECM) enzymes in collagen degradation, as a target for anticancer drugs","volume":"31","author":"Matejczyk","year":"2016","journal-title":"J. Enzym. Inhib. Med. Chem."},{"key":"ref_50","first-page":"283","article-title":"The prognostic significance of patient-reported outcomes in pancreatic cancer cachexia","volume":"6","author":"Robinson","year":"2008","journal-title":"J. Support. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0960-7404(02)00015-4","article-title":"Inflammation and the development of pancreatic cancer","volume":"10","author":"Farrow","year":"2002","journal-title":"Surg. Oncol."},{"key":"ref_52","first-page":"78","article-title":"Cancer-Associated Thrombosis","volume":"4","author":"Karimi","year":"2010","journal-title":"Open Cardiovasc. Med. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S1470-2045(05)70207-2","article-title":"Cancer and venous thromboembolism","volume":"6","author":"Prandoni","year":"2005","journal-title":"Lancet Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1055\/s-0043-1777304","article-title":"Cellular Components Contributing to the Development of Venous Thrombosis in Patients with Pancreatic Cancer","volume":"50","author":"Willems","year":"2024","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.thromres.2021.08.002","article-title":"Incidence, timing and risk factors of venous thromboembolic events in patients with pancreatic cancer","volume":"207","author":"Groen","year":"2021","journal-title":"Thromb. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1182\/blood.2020007338","article-title":"Venous thromboembolism in cancer patients: A population-based cohort study","volume":"137","author":"Mulder","year":"2021","journal-title":"Blood"},{"key":"ref_57","first-page":"396","article-title":"Risks and impacts of thromboembolism in patients with pancreatic cancer","volume":"29","author":"Chan","year":"2023","journal-title":"Hong Kong Med. J."},{"key":"ref_58","first-page":"236","article-title":"KRAS mutations in pancreatic cancer: Could we talk about a risk factor for the development of thromboembolic phenomena?","volume":"116","author":"Abad","year":"2024","journal-title":"Rev. Esp. Enferm Dig."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4827","DOI":"10.1200\/JCO.2009.22.7199","article-title":"Genetic Link Between Cancer and Thrombosis","volume":"27","author":"Boccaccio","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1055\/s-2008-1079260","article-title":"Tissue Factor\u2013Bearing Microparticles and Cancer","volume":"34","author":"Zwicker","year":"2008","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Versemann, L., Patil, S., Steuber, B., Zhang, Z., Kopp, W., Krawczyk, H.E., Kaulfu\u00df, S., Wollnik, B., Str\u00f6bel, P., and Neesse, A. (2022). TP53-Status-Dependent Oncogenic EZH2 Activity in Pancreatic Cancer. Cancers, 14.","DOI":"10.3390\/cancers14143451"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1001\/archinte.166.4.458","article-title":"Incidence of Venous Thromboembolism and Its Effect on Survival Among Patients with Common Cancers","volume":"166","author":"Chew","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S1470-2045(10)70218-7","article-title":"Definition and classification of cancer cachexia: An international consensus","volume":"12","author":"Fearon","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_64","first-page":"5271","article-title":"Incidence and frequency of cancer cachexia during chemotherapy for advanced pancreatic ductal adenocarcinoma","volume":"28","author":"Mitsunaga","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1038\/s41416-021-01301-4","article-title":"Pancreatic cancer cachexia: Three dimensions of a complex syndrome","volume":"124","author":"Kordes","year":"2021","journal-title":"Br. J. Cancer"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"10760296211051766","DOI":"10.1177\/10760296211051766","article-title":"Venous Thromboembolism in Japanese Patients with Pancreatic Cancer","volume":"27","author":"Suzuki","year":"2021","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Moik, F., van Es, N., Posch, F., Di Nisio, M., Fuereder, T., Preusser, M., Pabinger, I., and Ay, C. (2020). Gemcitabine and Platinum-Based Agents for the Prediction of Cancer-Associated Venous Thromboembolism: Results from the Vienna Cancer and Thrombosis Study. Cancers, 12.","DOI":"10.3390\/cancers12092493"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/01.sla.0000193959.44677.48","article-title":"A Clinical Outcome-Based Prospective Study on Venous Thromboembolism After Cancer Surgery","volume":"243","author":"Agnelli","year":"2006","journal-title":"Ann. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1002\/cam4.4397","article-title":"Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer","volume":"11","author":"Eurola","year":"2022","journal-title":"Cancer Med."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Willems, R.A.L., Michiels, N., Lanting, V.R., Bouwense, S., Broek, B.L.J.v.D., Graus, M., Klok, F.A., Koerkamp, B.G., de Laat, B., and Roest, M. (2023). Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care. Cancers, 15.","DOI":"10.3390\/cancers15143546"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s11739-012-0784-y","article-title":"A modified Khorana risk assessment score for venous thromboembolism in cancer patients receiving chemotherapy: The Protecht score","volume":"7","author":"Verso","year":"2012","journal-title":"Intern. Emerg. Med."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Frere, C., Gourgou, S., Winter, A., Gauthier, L., Canivet, C., Crichi, B., Marjanovic, Z., Yannoutsos, A., Bensaoula, O., and Buscail, L. (2025). Risk Assessment Models for Predicting Venous Thromboembolism in Patients with Pancreatic Cancer. Cancers, 17.","DOI":"10.3390\/cancers17040597"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annonc.2022.12.014","article-title":"Venous thromboembolism in cancer patients: ESMO Clinical Practice Guideline","volume":"34","author":"Falanga","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1470-2045(22)00160-7","article-title":"2022 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19","volume":"23","author":"Farge","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Chen, J.-S., Hung, C.-Y., Chang, H., Liu, C.-T., Chen, Y.-Y., Lu, C.-H., Chang, P.-H., Hung, Y.-S., and Chou, W.-C. (2018). Venous Thromboembolism in Asian Patients with Pancreatic Cancer Following Palliative Chemotherapy: Low Incidence but a Negative Prognosticator for Those with Early Onset. Cancers, 10.","DOI":"10.3390\/cancers10120501"},{"key":"ref_76","first-page":"67","article-title":"Guidelines for the pre-vention and treatment of venous thromboembolism in non-surgically treated cancer patients","volume":"12","author":"Wojtukiewicz","year":"2016","journal-title":"Oncol. Clin. Pract."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1200\/JCO.1986.4.4.509","article-title":"Pancreatic carcinoma and Trousseau\u2019s syndrome: Experience at a large cancer center","volume":"4","author":"Pinzon","year":"1986","journal-title":"J. Clin. Oncol."},{"key":"ref_78","first-page":"325","article-title":"Pancreatic cancer and thromboembolic disease, 150 years after Trousseau","volume":"4","author":"Ansari","year":"2015","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1159\/000207195","article-title":"Marantic Endocarditis Associated with Pancreatic Cancer: A Case Series","volume":"3","author":"Jameson","year":"2009","journal-title":"Case Rep. Gastroenterol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1001\/archinte.162.16.1880","article-title":"The Clinical Usefulness of D-Dimer Testing in Cancer Patients with Suspected Deep Venous Thrombosis","volume":"162","author":"Wolde","year":"2002","journal-title":"Arch. Intern. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"4296","DOI":"10.1182\/bloodadvances.2019001052","article-title":"Systematic review and meta-analysis of test accuracy for the diagnosis of suspected pulmonary embolism","volume":"4","author":"Patel","year":"2020","journal-title":"Blood Adv."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Wauthier, L., Favresse, J., Hardy, M., Douxfils, J., Le Gal, G., Roy, P.-M., van Es, N., Ay, C., Cate, H.T., and Borght, T.V. (2022). D-dimer Testing in Pulmonary Embolism with a Focus on Potential Pitfalls: A Narrative Review. Diagnostics, 12.","DOI":"10.3390\/diagnostics12112770"},{"key":"ref_83","first-page":"1035","article-title":"How we manage a high D-dimer","volume":"109","author":"Franchini","year":"2024","journal-title":"Haematologica"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1136\/jcp.2010.076349","article-title":"Elevated D-dimers are also a marker of underlying malignancy and increased mortality in the absence of venous thromboembolism","volume":"63","author":"Knowlson","year":"2010","journal-title":"J. Clin. Pathol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1056\/NEJMoa1909159","article-title":"Diagnosis of Pulmonary Embolism with d -Dimer Adjusted to Clinical Probability","volume":"381","author":"Kearon","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3218","DOI":"10.1182\/blood-2021-153228","article-title":"Diagnostic Accuracy of D-Dimer for Pulmonary Embolism and Lower Limb Deep Vein Thrombosis Testing in People with Cancer: A Meta-Analysis","volume":"138","author":"Parpia","year":"2021","journal-title":"Blood"},{"key":"ref_87","first-page":"zuab020.198","article-title":"Different D-dimer algorithms to rule out pulmonary embolism in patients with cancer: A comparative study","volume":"10","author":"Silva","year":"2021","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.thromres.2020.09.031","article-title":"Increased D-dimer predicts the risk of cancer-associated recurrent venous thromboembolism and venous thromboembolism: A systematic review and meta-analysis","volume":"196","author":"Yang","year":"2020","journal-title":"Thromb. Res."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1111\/j.1538-7836.2005.01413.x","article-title":"The prognostic value of the D-dimer test in cancer patients treated with and without low-molecular-weight heparin","volume":"3","author":"Klerk","year":"2005","journal-title":"J. Thromb. Haemost."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"14791641241236894","DOI":"10.1177\/14791641241236894","article-title":"A pharmacoepidemiological nested case-control study of risk factors for venous thromboembolism with the focus on diabetes, cancer, socioeconomic group, medications, and comorbidities","volume":"21","author":"Myllylahti","year":"2024","journal-title":"Diabetes Vasc. Dis. Res."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.thromres.2018.02.144","article-title":"Direct oral anticoagulant (DOAC) versus low-molecular-weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): A systematic review and meta-analysis","volume":"173","author":"Li","year":"2019","journal-title":"Thromb. Res."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1002\/rth2.12359","article-title":"Direct oral anticoagulants compared to low-molecular-weight heparin for the treatment of cancer-associated thrombosis: Updated systematic review and meta-analysis of randomized controlled trials","volume":"4","author":"Moik","year":"2020","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.23.00294","article-title":"Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: ASCO Guideline Update","volume":"41","author":"Key","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"100171","DOI":"10.1016\/j.tru.2024.100171","article-title":"The current landscape of factor XI inhibitors","volume":"15","author":"Engelen","year":"2024","journal-title":"Thromb. Updat."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1056\/NEJMoa1405760","article-title":"Factor XI Antisense Oligonucleotide for Prevention of Venous Thrombosis","volume":"372","author":"Bethune","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1001\/jama.2019.20687","article-title":"Effect of Osocimab in Preventing Venous Thromboembolism Among Patients Undergoing Knee Arthroplasty: The FOXTROT Randomized Clinical Trial","volume":"323","author":"Weitz","year":"2020","journal-title":"JAMA"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1056\/NEJMoa2105872","article-title":"Abelacimab for Prevention of Venous Thromboembolism","volume":"385","author":"Verhamme","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1056\/NEJMoa2113194","article-title":"Milvexian for the Prevention of Venous Thromboembolism","volume":"385","author":"Weitz","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1200\/JCO.2014.55.1481","article-title":"Efficacy of Prophylactic Low\u2013Molecular Weight Heparin for Ambulatory Patients with Advanced Pancreatic Cancer: Outcomes from the CONKO-004 Trial","volume":"33","author":"Pelzer","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.ejca.2011.10.017","article-title":"Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer","volume":"48","author":"Maraveyas","year":"2012","journal-title":"Eur. J. 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