Thromboembolic Events in Malignant Pleural Mesothelioma

Köksal, Deniz; Safak, Ozge; Özcan, Ayşenaz; Agackiran, Yetkin; Ertürk, Hakan; Fındık, Göktürk

doi:10.1177/1076029614564861

Cited by 6 publications

(10 citation statements)

References 28 publications

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“…2 Postoperative VTE in patients with mesothelioma is estimated to be between 5% and 28%, varying by the nature of the surgical procedure. [3][4][5] In our previous reported experience with extrapleural pneumonectomies for patients with mesothelioma, we reported a 6.4% incidence of deep vein thrombosis (DVT) and a 1.5% incidence of pulmonary embolism (PE) in a nonscreened sample. 6 The baseline risk of DVT is elevated in all patients presenting with pleural mesothelioma.…”

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confidence: 99%

Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma

León

Bravo‐Iñiguez

Fox

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Objective-The purpose of this study was to determine the incidence of venous thromboembolism and utility of a routine surveillance program in patients undergoing surgery for mesothelioma.Methods-Patients undergoing pleurectomy from May 2016 to August 2018 were included. A standardized surveillance program to look for venous thromboembolism in this group included noninvasive studies every 7 days postoperatively or earlier if symptomatic. All patients received external pneumatic compression sleeves in addition to prophylactic heparin. If deep vein thrombosis or pulmonary embolus was discovered, heparin drip was initiated until conversion to therapeutic anticoagulation.Results-A total of 100 patients underwent pleurectomy for mesothelioma. Seven patients were found to have preoperative deep vein thrombosis, and as such only 93 patients were included for analysis. The median age of patients at surgery was 71 years (30-85 years). During the study, 30 patients (32%) developed evidence of thrombosis; 20 patients (22%) developed only deep vein thrombosis without embolism, 3 patients (3%) developed only pulmonary embolism, and 7 patients (7%) developed both deep vein thrombosis and pulmonary embolus. Of the 27 patients who developed deep vein thrombosis, 9 (33%) were asymptomatic at the time of diagnosis, and none of these developed a pulmonary embolus or other bleeding complications. There were 2 (2%) events of major postoperative bleeding related to therapeutic anticoagulation.Conclusions-The incidence of venous thromboembolism is high (32%) among patients undergoing surveillance after pleurectomy for mesothelioma. Up to 33% of patients with deep vein thrombosis are asymptomatic at the time of diagnosis, and the incidence of complications related to anticoagulation is low. Routine surveillance may be useful to diagnose and treat deep vein thrombosis before it progresses to symptomatic or fatal pulmonary embolus.

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confidence: 99%

Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma

León

Bravo‐Iñiguez

Fox

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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“…14 35 36 38 39 40 42 43 46 47 51 52 56 70 74 75 77 83 87 Thromboprophylaxis was not reported in 46 studies. 7 26 27 28 29 31 32 34 37 45 48 49 53 54 55 57 58 60 63 64 65 68 69 71 72 76 79 80 82 84 89 93 94 95 96 97 100 102 103 107 110 112 116 120 122 123…”

Section: Resultsmentioning

confidence: 99%

“…70 VTE was the outcome in 81 studies, 114,[117][118][119][120][121][122][123] ATE in 4 studies, 34,62,69,109 and a combination of ATE and VTE in 15 studies. 37,38,44,49,65,71,89,[93][94][95]102,103,111,115,116 The patents received thromboprophylaxis in 10 studies, 30,33,41,50,67,78,87,106,119,121 some patients received thromboprophylaxis in 19 studies, 3,44,59,61,66,73,81,85,86,90-92,99,101,104,108 111,113,115 and no thromboprophylaxis was used in 25 studies. 14,35,36,[38][39][40]42,43,46,…”

Section: Resultsmentioning

confidence: 99%

Platelet Parameters as Biomarkers for Thrombosis Risk in Cancer: A Systematic Review and Meta-analysis

Malte

Højbjerg

Larsen

2023

Semin Thromb Hemost

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Cancer-associated thrombosis (CAT) is a major cause of both morbidity and mortality in cancer patients. Platelet count has been investigated as a predictor of CAT in various settings while knowledge on platelet activation parameters is sparse. This report provides a systematic review and meta-analysis on available literature on associations between platelet count and/or function and arterial and venous thrombosis in adult cancer patients. The review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed and Embase were searched up to March 2022. The National Heart, Lung, and Blood Institute's tools were used for quality assessment. In total, 100 studies were included which investigated the association between CAT and platelet count (n = 90), platelet indices (n = 19), and platelet function/activation markers (n = 13) in patients with solid cancers (n = 61), hematological cancers (n = 17), or mixed cancer types (n = 22). Eighty-one studies had venous thrombosis as their outcome measure, while 4 had arterial thrombosis and 15 studies had both. We found significantly elevated odds ratio of 1.50 (95% confidence interval: 1.19–1.88) for thrombosis with higher platelet counts. We saw a tendency toward an association between markers of platelet activation in forms of mean platelet volume and soluble P selectin and both arterial and venous thrombosis. Only one study investigated dynamic platelet function using flow cytometry. In conclusion, platelet count is associated with CAT across different cancer types and settings. Platelet function or activation marker analysis may be valuable in assisting thrombosis risk assessment in cancer patients but is sparsely investigated so far.

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“…A study indicates that the incidence of pulmonary embolism in patients with pleural mesothelioma is 3.4%. 14 Mesothelioma cells secrete procoagulant factors and interleukin 6, which could enhance platelet function and thrombosis, and at the same time promote inhibition of fibrinolysis, leading to the formation of pulmonary embolism. 15 , 16 In addition, due to the patient’s anticoagulation therapy, considering the risk of bleeding during invasive procedures, no open pleural biopsy was performed.…”

Section: Discussionmentioning

confidence: 99%

A Case of Pulmonary Embolism with Sarcomatoid Malignant Pleural Mesothelioma with Long-Term Pleural Effusion

Gu¹,

Lei²,

Duan³

et al. 2021

OTT

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Background: Malignant pleural mesothelioma (MPM) is a highly aggressive tumor that originates from pleural mesothelial cells. In recent years, with the development of asbestosrelated industries and the increase in air pollution, its incidence has been increased. The incidence of pulmonary embolism combined with sarcomatoid MPM is very low and the prognosis is extremely poor. We here report a case of a patient with long term of pleural effusion and finally diagnosed as pulmonary embolism with sarcomatoid MPM. Case: A 75-year-old male with a 30-year history of asbestos exposure was admitted to our hospital due to chest pain and difficulty in breathing after exercise. Radiologic examination revealed pleural effusion, computed tomography pulmonary angiography (CTPA) suggests pulmonary embolism, and we consider pleural effusion caused by pulmonary embolism. After anticoagulant therapy for pulmonary embolism and pleural puncture to reduce pleural effusion, the patient's symptoms improved. However, after that, the patient was still admitted to the hospital several times because of recurrent chest pain and dyspnea symptoms, and radiologic examination always showed unexplained pleural effusion. Finally, pathological and immunohistochemical examinations of the pleural biopsy specimens were performed, and the diagnosis was confirmed as sarcomatoid MPM. Conclusion:In summary, sarcomatoid MPM with pulmonary embolism is relatively rare, and the prognosis is poor. Clinicians need to be alert to its occurrence. When the first diagnosis is confirmed and the effect of targeted treatment is still not good, the possibility of other diseases should be considered. In clinical practice, pleural biopsy guided by PET-CT is a good choice for patients with sarcomatoid MPM who cannot tolerate open pleural biopsies or thoracoscopy. And patients should undergo pleural morphology and immunohistochemistry as soon as possible, which are helpful for timely diagnosis.

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Thromboembolic Events in Malignant Pleural Mesothelioma

Abstract: The rate of TEEs was 7.9%. Presence of thrombocytosis, disease stage, and histopathology did not affect the incidence of TEEs.

Cited by 6 publications

References 28 publications

Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma

Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma

Platelet Parameters as Biomarkers for Thrombosis Risk in Cancer: A Systematic Review and Meta-analysis

A Case of Pulmonary Embolism with Sarcomatoid Malignant Pleural Mesothelioma with Long-Term Pleural Effusion

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