Characteristics and outcomes of cancer patients who develop pulmonary embolism: A cross‑sectional study

Abstract

Pulmonary embolism (PE), along with deep vein thrombosis, are collectively known as venous thromboembolism (VTE). Predisposing factors for PE include post-operative conditions, pregnancy, cancer and an advanced age; of note, a number of genetic mutations have been found to be associated with an increased risk of PE. The association between cancer and VTE is well-established, and cancer patients present a higher risk of a thrombotic event compared to the general population. In addition, PE is a significant cause of morbidity and mortality among cancer patients. The aim of the present study was to illustrate the clinical characteristics, laboratory findings, radiology features and outcomes of cancer patients who developed PE, collected from an anticancer hospital. For this purpose, adult cancer patients diagnosed with PE by imaging with computed tomography pulmonary angiography were enrolled. The following data were recorded: Demographics, comorbidities, type of cancer, time interval between cancer diagnosis and PE occurrence, the type of therapy received and the presence of metastases, clinical signs and symptoms, predisposing factors for PE development, laboratory data, radiological findings, electrocardiography findings, and the type of therapy received for PE and outcomes in a follow-up period of 6 months. In total, 60 cancer patients were enrolled. The majority of the cancer patients were males. The most common type of cancer observed was lung cancer. The majority of cases of PE occurred within the first year from the time of cancer diagnosis, while the majority of patients had already developed metastases. In addition, the majority of cancer patients had received chemotherapy over the past month, while they were not receiving anticoagulants and had central obstruction. A large proportion of patients had asymptomatic PE. The in-hospital mortality rate was 13.3% and no relapse or mortality were observed during the follow-up period. The present study demonstrates that elevated levels of lactic acid and an increased platelet count, as well as low serum levels of carcinoembryonic antigen, albumin and D-dimer, may be potential biomarkers for asymptomatic PE among cancer patients.

The incidence and clinical characteristics of pulmonary embolism in oncologic patients

“…It was detected that dyspnea was a higher percentage of symptoms among cancer patients with PE which is in agreement with different studies in oncogenic patients as regards dyspnea [23] 24. In a study by Chlapoutakis et al (2022) [23], chest pain was detected as a lower clinical presentation (39.4%) than in the present study. This can be explained by the fact that, in our study, patients with breast cancer were higher than other malignancies and more likely to have dyspnea and chest pain, which are warning signs of malignancy for the examination of PE.…”

“…Since incidental PE is common in malignancies of the pancreas, lungs, and uterus and 100% of PE identified in chest MDCT throughout the staging of cancer, patients should have nearby follow-up and exploration for any PE in chest MDCT in the course of staging and follow up [22]. It was detected that dyspnea was a higher percentage of symptoms among cancer patients with PE which is in agreement with different studies in oncogenic patients as regards dyspnea [23] 24. In a study by Chlapoutakis et al (2022) [23], chest pain was detected as a lower clinical presentation (39.4%) than in the present study.…”

Characteristics and risk factors for advanced lung cancer with pulmonary embolism: A cross‐sectional, case–control study

“…The overall risk of venous thromboembolism (VTE), which consists of DVT and PE, in patients with malignant tumors was reported to be nearly seven times higher than in those without cancer. 3 As one of the most common cancers worldwide, lung cancer was reported to be the most frequent cancer susceptible to PE, [4][5][6][7] accounting for 23.5% 4 of PE patients with malignancy. Moreover, lung cancer patients with PE were at higher risk of in-hospital death compared to patients with PE and other malignancies combined.…”