Clinical Course of Pulmonary Embolism in Lung Cancer Patients

Abstract

Background: Although lung cancer is the most common malignancy diagnosed in patients with venous thromboembolism (VTE), data regarding pulmonary embolism (PE) in lung cancer patients are limited. Objectives: To investigate the clinicoradiological features, clinical course and survival of lung cancer patients with PE. Methods: We performed a retrospective case-control study investigating the clinical course and survival of 40 lung cancer patients with PE (PE group). The control group (non-PE group) consisted of 80 lung cancer patients without VTE, treated during the same period. Results: Adenocarcinoma (45.0%, n = 18) was the most common histological type of lung cancer and when PE was diagnosed, the majority of the lung cancer patients were in stages IIIB (37.5%, n = 15) and IV (47.5%, n = 19). Thirty-four patients (85.0%) were diagnosed with PE within 12 months of the diagnosis of lung cancer. The median survival from the diagnosis of PE was 3.5 months in the PE group, but the survival rates revealed no significant difference between the two groups (p = 0.249). In both groups, the most common cause of death was lung cancer progression (76.9 and 80.3%, respectively), followed by chemotherapy-related septic shock (19.2 and 16.7%, respectively). Conclusions: In lung cancer patients, PE may not be the main cause of death, but one of the various complications of lung cancer, despite suggesting a poor prognosis.

Pulmonary embolism concurrent with lung cancer and central emboli predict mortality in patients with lung cancer and pulmonary embolism

“…Thus, the possibility that provoking risk factors for VTE might contribute to the development of PE cannot be excluded. As reported in previous studies (6,11), most patients with PE had advanced stage lung cancer in the present study. However, early stage (stage I) lung cancer was significantly more common and stage III was significantly less common in the concurrent group.…”

“…The occurrence of VTE in lung cancer has a prognostic implication, in that the survival of lung cancer patients with PE was shorter than that of those without PE (10). However, most deaths in patients with lung cancer and PE or VTE have been attributed to lung cancer rather than thromboembolism (11). These findings suggest that VTE may be a marker of an advanced stage cancer or of a more biologically aggressive tumor (12).…”

Prevalence and Predictors of Pulmonary Embolism in Korean Patients with Exacerbation of Chronic Obstructive Pulmonary Disease

“…As described in an earlier study [17], PE was diagnosed on CT scan as a sharply delineated pulmonary arterial filling defect present in at least two consecutive image sections and located centrally within the vessel or with acute angles at its interface with the vessel wall. DVT was defined as a low-attenuating partial or complete intraluminal filling defect surrounded by a high-attenuating ring of enhanced blood that was seen on at least two consecutive transverse images [18].…”

Clinical Characteristics of Patients with Peripheral Pulmonary Embolism

“…A proximal DVT was defined as a thrombosis at the level of the popliteal vein or above and a distal DVT as a thrombosis affecting the axial calf veins. The changes in the PE upon follow-up CT scan were classified as follows [16]: (1) normalization, when no PE was identified; (2) improvement, if the PE was remarkably reduced in size and/or extent; (3) no change, if no remarkable change was noted; (4) aggravation, when the size and/or extent of the PE had progressed; and (5) undetermined, when objective assessment was difficult. …”