Incidental pulmonary embolism in oncologic patients—a systematic review and meta-analysis

Meyer, Hans‐Jonas; Wienke, Andreas; Surov, Alexey

doi:10.1007/s00520-020-05601-y

Cited by 30 publications

(24 citation statements)

References 42 publications

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“…According to another study by Ohashi et al ( 13 ), the most common type of cancer associated with the occurrence of PE was pancreatic cancer and the majority of the patients were at an advanced stage when diagnosed with PE. Furthermore, Meyer et al ( 14 ), in their study on cancer patients with PE, found that 3,36% had asymptomatic PE. The most common type of cancer was prostate cancer, followed by hepatobiliary carcinoma and pancreatic cancer ( 14 ).…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, Meyer et al ( 14 ), in their study on cancer patients with PE, found that 3,36% had asymptomatic PE. The most common type of cancer was prostate cancer, followed by hepatobiliary carcinoma and pancreatic cancer ( 14 ). In another study by Silva et al ( 4 ), it was found that the majority of the cancer patients who developed PE were female and the most common types of cancer were colorectal and lung cancer, most of which had metastases or had received chemotherapy.…”

Section: Discussionmentioning

confidence: 97%

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Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study

et al. 2022

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Pulmonary embolism (PE), along with deep vein thrombosis, are collectively known as venous thromboembolism (VTE). Predisposing factors for PE include post-operative conditions, pregnancy, cancer and an advanced age; of note, a number of genetic mutations have been found to be associated with an increased risk of PE. The association between cancer and VTE is well-established, and cancer patients present a higher risk of a thrombotic event compared to the general population. In addition, PE is a significant cause of morbidity and mortality among cancer patients. The aim of the present study was to illustrate the clinical characteristics, laboratory findings, radiology features and outcomes of cancer patients who developed PE, collected from an anticancer hospital. For this purpose, adult cancer patients diagnosed with PE by imaging with computed tomography pulmonary angiography were enrolled. The following data were recorded: Demographics, comorbidities, type of cancer, time interval between cancer diagnosis and PE occurrence, the type of therapy received and the presence of metastases, clinical signs and symptoms, predisposing factors for PE development, laboratory data, radiological findings, electrocardiography findings, and the type of therapy received for PE and outcomes in a follow-up period of 6 months. In total, 60 cancer patients were enrolled. The majority of the cancer patients were males. The most common type of cancer observed was lung cancer. The majority of cases of PE occurred within the first year from the time of cancer diagnosis, while the majority of patients had already developed metastases. In addition, the majority of cancer patients had received chemotherapy over the past month, while they were not receiving anticoagulants and had central obstruction. A large proportion of patients had asymptomatic PE. The in-hospital mortality rate was 13.3% and no relapse or mortality were observed during the follow-up period. The present study demonstrates that elevated levels of lactic acid and an increased platelet count, as well as low serum levels of carcinoembryonic antigen, albumin and D-dimer, may be potential biomarkers for asymptomatic PE among cancer patients.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study

et al. 2022

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“…With the improved image resolution and frequent use of multi‐detector CT scanners, 4 the prevalence of incidental VTE has increased. A recent large meta‐analysis showed that the overall frequency of incidental pulmonary embolism (PE) was 3.36% in oncology patients 5 . Several studies have evaluated the prognosis and the clinical course of incidental VTE in the cancer population, but the optimal management of these patients is still debated.…”

Section: Introductionmentioning

confidence: 99%

“…A recent large meta-analysis showed that the overall frequency of incidental pulmonary embolism (PE) was 3.36% in oncology patients. 5 Several studies have evaluated the prognosis and the clinical course of incidental VTE in the cancer population, but the optimal management of these patients is still debated. Current international guidelines recommend the same management for both clinically suspected and incidentally detected cancer-associated VTE, 6,7 but the supporting evidence is limited to mostly observational studies.…”

Section: Introductionmentioning

confidence: 99%

Outcomes among patients with cancer and incidental or symptomatic venous thromboembolism: A systematic review and meta‐analysis

Caiano

Carrier

Marshall

et al. 2021

Journal of Thrombosis and Haemostasis

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Summary Background Patients with cancer have an increased risk of venous thromboembolism (VTE) and it is commonly detected incidentally. The outcomes and optimal management for patients with cancer and incidental VTE remain debated. Objectives We conducted a systematic review and meta‐analysis to evaluate the outcomes in patients with cancer and incidentally detected VTE compared to those with symptomatic events. Patients/Methods We searched the electronic databases and included randomized controlled trials (RCTs) and observational studies reporting recurrent VTE, major bleeding events, and mortality in patients with cancer and incidental VTE compared to symptomatic VTE. Results We included 23 studies for the systematic review: 3 RCTs and 20 observational studies. The meta‐analysis of the 3 RCTs showed a significantly lower rate of VTE recurrence at 6 months in patients with incidental VTE compared to those with symptomatic VTE (relative risk [RR] 0.62, 95% confidence interval [CI] 0.44–0.87). The risk of major bleeding events at 6 months was numerically higher with incidental VTE compared to symptomatic VTE (RR 1.47, 95% CI 0.99–2.20). There was no difference in overall mortality. Conclusions Among patients with cancer, incidental VTE was associated with a lower rate of VTE recurrence compared to symptomatic VTE, with a trend in increased major bleeding events. The risk‐benefit ratio of anticoagulation may differ between incidental and symptomatic events and should be considered in patient management.

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“…The increased use of CT scans in cancer patients and the introduction of multiple-detector CT scanners with their imaging quality that evolved over recent years have increased the incidence of incidental cancer-associated PE. In a recent systematic review and meta-analysis including 28 626 patients, the prevalence of incidental PE in cancer patients was 3.4% (95% confidence interval [CI], 3.2%-3.6%), with the lowest frequency observed in tumors of male reproductive organs (0.8%, 95% CI, 0.2%-1.4%) and the highest observed in patients with prostate cancer (8.6%, 95% CI 3.7%-13.4%) [5]. Several studies have evaluated the prognosis and the clinical course of incidental VTE in the cancer population, but the optimal management of these patients is still debated.…”

Section: Introductionmentioning

confidence: 99%

How to treat incidental pulmonary embolism in cancer patients? Recent advances

Delluc

Wang

2021

Kardiol Pol

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Patients with cancer have an increased risk of venous thromboembolism (VTE). In addition, due to the growing use of computed tomography scans in these patients and the improved scanners and imaging qualities, many cases of VTE are diagnosed incidentally on images obtained for reasons other than suspicion of VTE. Studies have shown that as many as half of all cancer-related pulmonary embolism (PE) cases could be incidental. Despite the common occurrence, the optimal management of incidental PE in patients with cancer remains unclear. This review will summarize pertinent literature related to incidental PE in the cancer population and discuss their outcomes and recommended treatments.

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Incidental pulmonary embolism in oncologic patients—a systematic review and meta-analysis

Cited by 30 publications

References 42 publications

Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study

Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study

Outcomes among patients with cancer and incidental or symptomatic venous thromboembolism: A systematic review and meta‐analysis

How to treat incidental pulmonary embolism in cancer patients? Recent advances

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