Abstract
ObjectivesLung cancer patients have been reported to have a high incidence of venous thromboembolism (VTE) and a high recurrence rate of VTE. However, there are no detailed reports of VTE in lung cancer patients who underwent surgery after induction therapy. We examined the incidence and clinical features of VTE in these patients.MethodsWe retrospectively evaluated 89 patients with non-small cell lung cancer who underwent surgery after induction therapy at our department between April 2009 and March 2018. The incidence of VTE, clinical features, and long-term prognosis were retrospectively examined.ResultsAmong the 89 patients, 4 (4.5%) developed VTE, and there was no significant difference in the background characteristics between patients with and without VTE. All four patients developed VTE during preoperative treatment. In the patients with VTE, anticoagulant therapy with oral anticoagulants was administered after heparinization, and the median duration of anticoagulant therapy was 18.7 months. There were no cases of symptomatic VTE recurrence after surgery, regardless of lung cancer recurrence. Although the overall survival (OS) showed no significant difference between patients with and without VTE, the disease-free survival was significantly shorter in patients with VTE than in those without it (median 6.3 vs. 71.6 months, p < 0.01).ConclusionsIn induction cases, the incidence of VTE was 4.5%, and it can at least be stated that no symptomatic VTE developed or recurred after surgery. Patients with VTE in induction therapy had short progression-free survival and required careful follow-up after surgery.
Highlights
Venous thromboembolism (VTE) consists of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT)
Thrombus formation is promoted as follows: coagulation factors are activated by tissue factors and procoagulants secreted from cancer cells, and vascular endothelial cells are damaged by mucin-like substances and cytokines derived from cancer cells [1]
Patients with unresectable/recurrent cancer are at a high risk of VTE recurrence, due to the persistent hypercoagulable state caused by cancer
Summary
Venous thromboembolism (VTE) consists of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT). VTE occurs in 4–20% of cancer patients, and lung cancer is reported to carry a high risk of VTE complications among solid tumors [1–3]. Cancer patients have a high VTE recurrence rate [4]. Thrombus formation is promoted as follows: coagulation factors are activated by tissue factors and procoagulants secreted from cancer cells, and vascular endothelial cells are damaged by mucin-like substances and cytokines derived from cancer cells [1]. Patients with unresectable/recurrent cancer are at a high risk of VTE recurrence, due to the persistent hypercoagulable state caused by cancer. If a cancer-free status can be obtained by surgery after induction treatment for advanced lung cancer, the internal environment surrounding VTE may differ from
Sign-in/Register to view highlights & summary 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.
