Epidemiology and risk factors for venous thromboembolism in lung cancer

Ay, Cihan; Ünal, Umut

doi:10.1097/cco.0000000000000262

Cited by 28 publications

(33 citation statements)

References 36 publications

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“…There is evidence that disturbed hemostasis plays a role in the metastatic capacity of solid tumors [40]. Increased activation of the blood coagulation along with the subsequent fibrinolysis evidenced in our cohort of lung cancer patients by higher MP-TF activity and thrombin leads to elevated D-dimer levels in patients with ED, related to poor prognosis in several studies on patients with solid tumors, including lung cancer [41]. These observations are in line with the study by Zhang et al [42].…”

Section: Discussionsupporting

confidence: 89%

Altered fibrin clot properties in advanced lung cancer: strong impact of cigarette smoking

et al. 2019

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Background Dense fibrin networks resistant to lysis have been reported in patients at high risk of thromboembolism. Little is known about fibrin clot properties in cancer. We investigated fibrin clot properties and their determinants in patients with inoperable lung cancer. Methods We enrolled 150 patients with advanced lung cancer prior to therapy and 90 control subjects matched by age, sex, cardiovascular disease, and diabetes. Plasma clot permeability (K s), turbidimetric analysis of clot formation, clot lysis time (CLT), microparticle-associated tissue factor (MP-TF) activity, thrombin generation, and serum cotinine levels were determined. Results Lung cancer patients, compared with controls, formed at a faster rate (− 8.1% lag phase) denser plasma fibrin networks (− 27.2% K s) that displayed impaired lysis (+ 26.5% CLT), along with 19.5% higher MP-TF activity and 100% higher peak thrombin generated, also after adjustment for potential confounders. Cotinine levels were associated with fibrin maximum absorbance (r = 0.20, p = 0.016) and K s (r = − 0.50, p < 0.0001) in cancer patients. On multivariate regression analysis, an increase in cotinine levels was a predictor of low K s (the lower quartile, < 5.8 × 10 −9 cm 2 ; odds ratio = 1.21 per 10 ng/ml, 95% confidence interval 1.02-1.46), but not CLT. Conclusion Advanced lung cancer is associated with the prothrombotic plasma clot phenotype largely driven by smoking.

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Section: Discussionsupporting

confidence: 89%

Altered fibrin clot properties in advanced lung cancer: strong impact of cigarette smoking

et al. 2019

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“…It is well known that D-Dimer has been considered as a remarkable predictor associated with VTE in cancer including lung cancer [4, 5]. Interestingly, D-Dimer has been as well confirmed to be a similar predictor of lung cancer.…”

Section: Introductionmentioning

confidence: 98%

The relationship between tumor markers and pulmonary embolism in lung cancer

Xiong

Zhao

et al. 2017

Oncotarget

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BackgroundTumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer.ResultsThe number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend < 0.001), CEA (R2 0.735, P0.003) and CYFRA21-1 (R2 0.718, P0.005) were positively correlated with D-Dimer in patients with pulmonary embolism. The multivariate logistic regression analysis showed that, for tumor markers, TMs panel (OR5.98, P < 0.001) had the strongest correlation with pulmonary embolism. The AUC (area under curve) of TMs panel and CEA were 0.82 [95%CI (0.71–0.95), P < 0.001] and 0.71 [95%CI (0.62–0.84), P 0.002] by ROC (receiver operating characteristic) curve analysis, respectively.Materials and MethodsTumor markers were compared between lung cancer patients complicated with pulmonary embolism and those without pulmonary embolism Then the correlation between each tumor marker as well as panel of combined TMs and D-Dimer as well as pulmonary embolism were analyzed for patients with pulmonary embolism.ConclusionsThere is a relationship between tumor markers and pulmonary embolism in patients with lung cancer. The panel of combined tumor markers is a valuable diagnostic marker for pulmonary embolism in lung cancer.

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“…[3][4][5] Moreover, retrospective studies have reported associations between VTE and longer length of stay, higher rate of clinical complications, higher in hospital mortality rate, greater disability upon discharge, and more cost for various patients. [6][7][8] Thus, a method to estimate risk of developing VTE in patients with lung cancer will be clinically valuable. Several risk factors for cancer-related VTE have been identified, including cancer type, age, gender, bed rest, central venous catheter (CVC), anticancer treatment, and so on.…”

Section: Introductionmentioning

confidence: 99%

“…Several risk factors for cancer-related VTE have been identified, including cancer type, age, gender, bed rest, central venous catheter (CVC), anticancer treatment, and so on. 7,9 Although several VTE risk score system have been published in the recent years, they rely on biochemical predictors or are not lung cancer specific and thus provide limited clinical benefit. [10][11][12] Hence, the aim of this retrospective cohort study was to study clinical predictors of VTE in Chinese patients with lung cancer and to develop a scoring system to provide a reliable estimate of VTE risk.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Risk Score for Prediction of Venous Thromboembolism in Patients With Lung Cancer

Zhang

et al. 2020

Clin Appl Thromb Hemost

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This study aimed to develop and validate a risk score for early prediction of venous thromboembolism (VTE) in patients with lung cancer. A total of 827 patients with lung cancer from February 2013 to February 2018 in our hospital were retrospectively analyzed. Demographic and clinicopathological variables independently correlated to VTE were applied to develop the risk score in the development group while examined in the validation group. The regression coefficients of multivariable logistic regression test were applied to assign a risk score system. The incidence of VTE was 12.3%, 12.7%, and 11.8% in all patients, in the development and validation groups, respectively. The 496 patients in the development group were classified into 3 groups: low risk (scores ≤3), moderate risk (scores 4-5), and high risk (scores ≥6). The risk of VTE was significantly and positively related to the risk scores in both development and validation groups. The risk score system aided proper stratification of patients with either high or low risk of VTE in the development and validation groups ( c statistic = 0.819 and 0.827, respectively). This risk score system based on the factors with most significant correlation showed good predictive ability and is potentially useful for predicting VTE in patients with lung cancer. However, it was developed and validated by a retrospective analysis and has significant limitations, and a prospective validation with all the classic variables assessing the thrombotic risk is needed for a solid conclusion.

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Epidemiology and risk factors for venous thromboembolism in lung cancer

Abstract: Knowledge about the epidemiology, risk factors, and prognostic value of VTE in lung cancer could help to prevent thrombotic complications and improve management of patients with lung cancer.

Cited by 28 publications

References 36 publications

Altered fibrin clot properties in advanced lung cancer: strong impact of cigarette smoking

Altered fibrin clot properties in advanced lung cancer: strong impact of cigarette smoking

The relationship between tumor markers and pulmonary embolism in lung cancer

Development and Validation of a Risk Score for Prediction of Venous Thromboembolism in Patients With Lung Cancer

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