Abstract
Venous thromboembolism (VTE) is a common complication of malignancies and epidemiological studies suggest that lung cancer belonged to the group of malignancies with the highest incidence rates of VTE. Risk factors for VTE in lung cancer patients are adenocarcinoma, NSCLC in comparison with SCLC, advanced disease, pneumonectomy, chemotherapy including antiangiogenic therapy. Other risk factors are pretreatment platelet counts and increased release of TF-positive microparticles. Elevated D-dimer levels do not necessarily indicate an increased risk of VTE but have been shown to be predictive for a worse clinical outcome in lung cancer patients. Mechanisms responsible for the increase in venous thrombosis in patients with lung cancer are not understood.Currently no biomarker is recognized as a predictor for VTE in lung cancer patients.Although several clinical trials have reported the efficacy of antithrombotic prophylaxis in patients with lung cancer who are receiving chemotherapy, further trials are needed to assess the clinical benefit since these patients are at an increased risk of developing a thromboembolism.
Highlights
Thromboembolism is a well recognized complication of malignant disease and it is known that cancer patients have a higher incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), compared to the general population [1]
Chew et al [14] investgated the incidence of VTE and the risk factors associated with development of VTE in a large popuation-based study of patients with non small cell (NSCLC) and small cell lung cancer (SCLC)
They observed that the risk of VTE is increased in patients with Non-small-cell lung cancer (NSCLC) at all stages who receive chemotherapy, but not erlotinib or BMS-275291, whether it is given as postoperative adjuvant therapy or fort he treatment of advanced disease [53]
Summary
Thromboembolism is a well recognized complication of malignant disease and it is known that cancer patients have a higher incidence of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), compared to the general population [1].The incidence of thromboembolic disease in general population is relatively low, about 1–3 per 1.000 per year [2] while among cancer patients, the occurrence of VTE is 4–7 times higher, depending on the type and the stage of cancer [3].It is estimated that cancer is responsible for 20 % of all cases of incident VTE [4].Epidemiological studies suggest that lung cancer belonged to the group of malignancies with the highest incidence rates [5,6,7,8,9] of VTE.The association between VTE and lung cancer has been reported more than 20 years ago [10, 11].Lung cancer is the leading cause of cancer death in the United States for both men and women, with over 156,000 deaths in 2011 in the United States [9]. Chew et al [14] investgated the incidence of VTE and the risk factors associated with development of VTE in a large popuation-based study of patients with non small cell (NSCLC) and small cell lung cancer (SCLC).
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