An analysis of incidental and symptomatic pulmonary embolism (PE) in medical oncology patients

Thaker, DA; Douglas, E.; Blazak, John; Xu, Wen; Hughes, Brett; Burge, Matthew; Steinke, Karin; Wyld, David

doi:10.1111/ajco.12650

Cited by 5 publications

(2 citation statements)

References 24 publications

(29 reference statements)

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“…It is important to note that the issues around the diagnosis of iPE are probably not specific to Canada; it is more likely a reflection of the numbers of iPE patients in PELICAN and PELICANOS being too low for any meaningful signal to emerge in isolation. Furthermore, given that PE occurs in 3.6% of all staging computed tomography scans and accounts for 40% of all cancer‐associated PE, management of this unexpected outcome is a common and important clinical scenario …”

Section: Discussionmentioning

confidence: 99%

Patient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)

Noble

Nelson

Scott

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractIntroduction: Previous research from the United Kingdom and Spain has identified several areas of unmet clinical and support need for cancer patients diagnosed with venous thromboembolism. It is not known whether such experiences are restricted to those countries health care systems and culture. We therefore evaluated patients' experience of cancer-associated thrombosis (CAT) within a Canadian setting. Methods:Purposive sampling of patients with CAT attending a regional thrombosis clinic in Vancouver was undertaken. Semistructured interviews were audio recorded, transcribed, and coded using NVivo software. A deductive approach was taken by applying the framework matrix from the original study to these data on a case-bycase basis. Results: Twenty patients (10 male, 10 female) aged 39 to 74 (mean, 63) representing a breadth of different cancers participated. Commonalities between the UK and Canadian patients included the traumatic nature of experiencing CAT, the need for information, and adaptive behaviors through ritualization. Two new themes were identified: (1) Patients with incidental pulmonary emboli (iPE) were usually telephoned about their thrombus with little support and suboptimal communication; and (2) cost implications of accessing low-molecular-weight heparin varied according to insurance cover. Patients were sometimes converted to warfarin for financial reasons. Conclusion: The distress associated with CAT is a common experience across different populations but may be ameliorated by early access to specialist services, information, and support. The current process for managing iPE could be improved with better communication and a dedicated clinical pathway. Funding issues may influence choice of anticoagulant. K E Y W O R D S cancer-associated thrombosis, cultural, patient experience, qualitative, venous thromboembolism | 155 NOBLE Et aL.

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Section: Discussionmentioning

confidence: 99%

Patient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)

Noble

Nelson

Scott

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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“…So, IPE is more often located on the segmental and subsegmental level without an occlusion of the vessel [1,30,31]. Correspondingly, the total embolic burden in incidental PE is lower than that in symptomatic PE [30][31][32]. Especially, subsegmental PE is of interest, which was defined as peripheral PE limited to the fifth order pulmonary arteries.…”

Section: Discussionmentioning

confidence: 99%

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

Meyer¹,

Wienke

Surov

2020

Support Care Cancer

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Purpose Incidental pulmonary embolism (IPE) is a common finding on computed tomography (CT). IPE is frequent in oncologic patients undergoing staging CT. The aim of this analysis was to provide the pooled frequency of IPE and frequencies of IPE in different primary tumors. Methods MEDLINE, SCOPUS, and EMBASE databases were screened for studies investigating frequency of IPE in oncologic staging CT up to February 2020. Overall, 12 studies met the inclusion criteria and were included into the present study. Results The pooled analysis yielded a total of 28,626 patients. IPE was identified in 963 patients (3.36%, 95% CI = 3.15; 3.57). The highest frequency was found in prostate cancer (8.59%, 95%CI = 3.74; 13.44), followed by hepatobiliary carcinoma (6.07%, 95%CI = 3.09; 9.05) and pancreatic cancer (5.65%, 95%CI = 3.54; 7.76). The lowest frequencies were identified in tumors of male reproductive organs (0.79%, 95%CI = 0.21; 1.37) and hematological diseases (1.11% 95%CI = 0.74; 1.48). Conclusion The overall frequency of IPE in oncologic patients was 3.36%. There are considerable differences in regard to primary tumors with the highest frequency in prostate cancer and pancreatic and hepatobiliary carcinomas.

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Incidental pulmonary emboli are associated with a very high probability of progressive malignant disease on staging CT scans

Goh

Tenant

2022

Jpn J Radiol

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An analysis of incidental and symptomatic pulmonary embolism (PE) in medical oncology patients

Cited by 5 publications

References 24 publications

Patient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)

Patient Experience of Living With Cancer‐Associated Thrombosis in Canada (PELICANADA)

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

Incidental pulmonary emboli are associated with a very high probability of progressive malignant disease on staging CT scans

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