Abstract
Background The natural history of patients with lung cancer and venous thromboembolism (VTE) has not been consistently evaluated. Methods We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the clinical characteristics, time course, and outcomes during anticoagulation of lung cancer patients with acute, symptomatic VTE. Results As of May 2017, a total of 1,725 patients were recruited: 1,208 (70%) presented with pulmonary embolism (PE) and 517 with deep vein thrombosis (DVT). Overall, 865 patients (50%) were diagnosed with cancer <3 months before, 1,270 (74%) had metastases, and 1,250 (72%) had no additional risk factors for VTE. During anticoagulation (median, 93 days), 166 patients had symptomatic VTE recurrences (recurrent DVT: 86, PE: 80), 63 had major bleeding (intracranial 11), and 870 died. The recurrence rate was twofold higher than the major bleeding rate during the first month, and over threefold higher beyond the first month. Fifty-seven patients died of PE and 15 died of bleeding. Most fatal PEs (84%) and most fatal bleeds (67%) occurred within the first month of therapy. Nine patients with fatal PE (16%) died within the first 24 hours. Of 72 patients dying of PE or bleeding, 15 (21%) had no metastases and 29 (40%) had the VTE shortly after surgery or immobility. Conclusion Active surveillance on early signs and/or symptoms of VTE in patients with recently diagnosed lung cancer and prescription of prophylaxis in those undergoing surgery or during periods of immobilization might likely help prevent VTE better, detect it earlier, and treat it more efficiently.
Highlights
Lung cancer is the most common malignancy, and a leading cause of death.[1]
Of 72 patients dying of pulmonary embolism (PE) or bleeding, 15 (21%) had no metastases and 29 (40%) had the venous thromboembolism (VTE) shortly after surgery or immobility
Patients with lung cancer are at increased risk for venous thromboembolism (VTE),[2,3,4,5,6] and VTE appearing in patients with cancer carries an increased risk for early mortality.[2,7]
Summary
Lung cancer is the most common malignancy, and a leading cause of death.[1]. Patients with lung cancer are at increased risk for venous thromboembolism (VTE),[2,3,4,5,6] and VTE appearing in patients with cancer carries an increased risk for early mortality.[2,7] there is scarce information in the literature on the clinical presentation, timecourse, and clinical outcomes of lung cancer patients developing VTE in real-life practice. A better knowledge of the burden of VTE in lung cancer patients, linked to adequate dissemination of the data, could likely help improve the awareness of attending doctors, nurses, and patients. A better understanding of at-risk patients and time course of VTE could likely help design better prevention strategies and detect VTE earlier. A better information on the natural history of VTE during the course of anticoagulant therapy could likely help design better therapeutic strategies (drugs, doses, duration) for this subgroup of patients with cancer. The natural history of patients with lung cancer and venous thromboembolism (VTE) has not been consistently evaluated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
