Correlation between clinicopathological characteristics of lung adenocarcinoma and the risk of venous thromboembolism

Zhang, Yuan; Shi, Zhongyue; Yi, Jiawen; Zhang, Shu; Feng, Wei; Zhu, Min; Hu, Bin; Zhang, Yuhui

doi:10.1111/1759-7714.14260

Cited by 3 publications

(3 citation statements)

References 47 publications

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“…Several similar reports have supported this view ( 20 , 21 ). In our study, 70% of all patients (63/90) were long-term bedridden due to their cancer condition, and this was shown to be the second strongest risk predictor of PE, with an OR of 4.166 (P<0.01), confirming previously reported risks in the study population of lung cancer patients ( 7 - 9 ).…”

Section: Discussionsupporting

confidence: 90%

“…In clinical practice, blood clots are the most significant risk factor of PE development, and VTE is a potentially life-threatening disease which leads to PE ( 6 ). Patients with cancer are 2–4 times more likely to have VTE compared to those without cancer, and several studies have shown that lung adenocarcinoma is the most common malignant tumor in patients with VTE ( 7 ), and approximately 3–13.9% of patients with lung cancers experience a complication with DVT, and 3.8% present with PE ( 8 , 9 ). With timely diagnosis and corresponding therapy, VTE is treatable, thus an effective method of risk assessment is urgently needed to provide early diagnosis and treatment for cancer patients.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study

Dong¹,

Tong²,

Wang³

et al. 2023

Transl Lung Cancer Res

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Background There is growing evidence that misdiagnosis contributes to the high mortality rate in lung cancer patients complicated with pulmonary embolism (PE). This current study analyzed predictors of PE in lung cancer patients with lower extremity deep venous thrombosis (DVT) with the aim of personalizing the treatment and management of patients with PE. Methods This retrospective case-control study included lung cancer patients with DVT at the emergency department of Shanghai Chest Hospital from January 2018 to December 2019. Patients were classified as having DVT with or without PE. The following characteristics were examined, including age, gender, smoking, hypertension, surgical trauma, hyperlipidemia, long-term bedridden status, calf swelling, coronary heart disease, chronic pulmonary disease, DVT location, DVT type, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, and D-dimer, and univariate and multivariate analyses were performed. Results A total of 90 patients with lung cancer and DVT were analyzed, of whom 60% (54/90) had PE. Those variables independently associated to PE were hypertension [odds ratio (OR): 7.883, 95% confidence interval (CI): 2.038–30.495, P=0.003], long-term bedridden status (OR: 4.166, 95% CI: 1.236–14.044, P=0.021), and D-dimer levels (OR: 2.123, 95% CI: 1.476–3.053, P=0.000) were identified as independent risk factors for PE. The cut-off value of the receiver operating characteristic (ROC) curve for predicting PE by presented scoring system according to the risk factors was 1.5 and the area under the curve (AUC) was 0.84 (P<0.001). Conclusions Hypertension, being bedridden for an extended period, and elevated serum D-dimer levels were independent risk factors of PE in lung cancer patients with lower extremity DVT. Novel strategies for patient management should be developed to decrease the risk of PE.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study

Dong¹,

Tong²,

Wang³

et al. 2023

Transl Lung Cancer Res

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“…In this study, we identified age as an independent risk factor for postoperative VTE, which is supported by many previous studies. The serum levels of procoagulant factors generally increase with age, and older patients are less mobile following surgery, resulting in a higher risk of VTE 22 . Although the Caprini score involves many predictive factors, some possible cancer-related risk factors are not included in the scoring system.…”

Section: Discussionmentioning

confidence: 99%

Incidence, risk factors, and outcomes of venous thromboembolism in patients undergoing surgery for retroperitoneal tumors: a propensity-matched retrospective cohort study

Guo

Zhao

et al. 2023

International Journal of Surgery

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Background: Venous thromboembolism (VTE) is a common postoperative complication; however, incidence and risk stratification of postoperative VTE in patients with retroperitoneal tumor remains unclear. We aim to quantify incidence, identify risk factors, and determine outcomes of VTE in patients undergoing retroperitoneal tumor surgery. Methods: We retrospectively reviewed characteristics, perioperative outcomes, and overall survival (OS) of patients (VTE and non-VTE) who underwent retroperitoneal tumor surgery between 2015 and 2020. Perioperative and oncologic outcomes were compared using propensity-matching and Cox analyses. Results: Of 1223 patients with retroperitoneal tumor surgery, 2.1% had VTE. Age (odds ratio [OR] 1.140, 95% confidence interval [CI] 1.053–1.239, P=0.004), recurrence (OR 1.851, 95% CI 1.241–2.761, P=0.003), and vascular resection (OR 2.036, 95% CI 1.054–3.934, P=0.034) were independent risk factors, with significant between-group differences regarding age, recurrence, sarcoma, organ resection, vascular resection, and operation time. No between-group differences in 30-day all-cause mortality (8% vs. 4%, OR 0.657, 95% CI 0.375–1.151, P=0.427) and major complications (12% vs. 8%, OR 0.775, 95% CI 0.483–1.244, P=0.572) were observed. Mean hospitalization duration (20.1 vs. 22.9 d, OR 1.153, 95% CI 1.022–1.386, P=0.033) and ICU stay (3.2 vs. 5.5 d, OR 1.193, 95% CI 1.034–1.347, P=0.012) were shorter in non-VTE versus VTE, respectively, with inferior OS (hazard ratio [HR] 2.090, 95% CI 1.014–4.308, P=0.046) in VTE. Conclusions: Age, recurrence, and vascular resection are positively associated with VTE, which is associated with inferior OS.

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Stratification of Risk Factors of Lung Cancer-Associated Venous Thromboembolism and Determining the Critical Point for Preemptive Intervention: A Systematic Review With Meta-analysis

Nwagha

Nweke²

2023

Clin Med Insights Oncol

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Background: Several biomarkers or risk factors have been identified and several prediction models exist. The major limitations inherent in these models include cost-ineffectiveness and lack of systematic stratification of risk factors resulting in the inclusion of clinically insignificant biomarkers in the models. This review aimed to systematically stratify the risk factors of lung cancer-associated venous thromboembolism (VTE) and determine the critical point for preemptive intervention. Methods: This systematic review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-analyses. We searched MEDLINE, PubMed, Cochrane Library, CINAHL, Academic Search Complete, and PsycINFO from the onset to June 2022. We included studies that reported the risk factors of lung cancer-associated VTE and corresponding risk estimates, irrespective of treatment status but studies were excluded if patients were on anti-VTE medications. We employed random effects models of meta-analysis and computed risk stability index and risk weight (Rw) to achieve the review objectives. The review protocol is registered with PROSPERO (CRD42022336476). Results: The clinically significant risk factors of VTE in lung cancer patients were D-dimer (odds ratio [OR] = 5.510, 95% CI = 2.6-11.7; Rw = 5.0), albumin (OR = 2.2, 95% CI = 1.0-4.8; Rw = 1.79), leukocyte (OR = 2.48, 95% CI = 1.9-3.2; Rw = 1.77), histological type (OR = 1.69 , 95% CI = 1.2-2.4; Rw = 1.3), age (OR = 1.56; Rw = 0.99), and hemoglobin (OR = 1.85, 95% CI = 1.3-2.6; Rw = 0.92). Based on the distribution of Rw across risk factors, the critical point (upper third of the upper quartile class) was 4.5 and may mark the point at which preemptive intervention should be commenced. Conclusions: Targeted screening for VTE in lung cancer patients could be patient-specific and should be based on a combination of the most significant risk factors required to meet the critical point, provided that such a combination is affordable as illustrated in the ALBAH model. Registration: The review protocol is registered with PROSPERO (ID: CRD42022336476).

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Correlation between clinicopathological characteristics of lung adenocarcinoma and the risk of venous thromboembolism

Cited by 3 publications

References 47 publications

Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study

Risk factors for pulmonary embolism in lung cancer patients with lower limb deep venous thrombosis: a case-control study

Incidence, risk factors, and outcomes of venous thromboembolism in patients undergoing surgery for retroperitoneal tumors: a propensity-matched retrospective cohort study

Stratification of Risk Factors of Lung Cancer-Associated Venous Thromboembolism and Determining the Critical Point for Preemptive Intervention: A Systematic Review With Meta-analysis

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