Characteristics and 6-Month Mortality of Medical Oncology Patients With Incidental and Symptomatic Pulmonary Embolism: A Single-Institutional Retrospective Longitudinal Analysis

Abstract

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan–Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up.

Incidentally Diagnosed With Pulmonary Embolism in Lung Cancer Patients: Comparison of Clinical Characteristics and Mortality With Symptomatic Pulmonary Embolism

“…16 We have previously investigated the prevalence of incidental and SPE in patients with solid organ malignancies at our institution over a five year period and found that the overall incidence of PE was 3.12%, of which up to 51.9% of the PEs were noted incidentally for cancer staging or treatment evaluation or cancer recurrence detection. 17 During the course of the analysis of the data, it came to our attention that the patients with lung cancer listed as one of four cancer types which had significantly higher risk for PE compared to others and lung cancer patients account for the largest population that developed IPE which is consistent with previous study.…”

“…A single-center, retrospective cohort study was conducted at the Ningbo First affiliated hospital of Ningbo University, a large metropolitan teaching hospital in southeast of China but different cancer with the earlier study. 17 All adult lung cancer patients (age ≥ 18 years) who developed incidental PE and symptomatic PE between January 2016 and June 2021 were eligible. Lung cancers were diagnosed by histologic or cytological examination and PE had to be objectively confirmed by standard radiological methods showing a high probability of PE.…”