Pulmonary embolism in cancer patients

Sawant, Sharada; Banumathy, S; Daddi, Anuprita; Dhir, Aditi

doi:10.4103/0019-509x.98936

Cited by 14 publications

(11 citation statements)

References 27 publications

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“…The risk for CTR-CVT is twice as high in survivors of several solid cancers and lymphoma compared with the general population ( 21 – 23 ). The long-term real-life data in this study reveal an even higher cumulative incidence after BC, with a cumulative CTR-CVT incidence of 71.8%.…”

Section: Discussionmentioning

confidence: 99%

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study

et al. 2023

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BackgroundThe administration of anticancer drugs in females with comorbidity increases the risk for cancer therapy-related cardiovascular toxicity (CTR-CVT), which in turn contributes to cardiovascular disease (CVD). Furthermore, a pathophysiological connection between cancer and cardiovascular disease may exist.ObjectiveTo assess the long-term risks and predictors of CTR-CVT, including clinical hypertension (HT), coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), as well as all-cause mortality in women diagnosed with early breast cancer (BC) and eligible for adjuvant chemotherapy in Sweden.MethodsData were extracted from Swedish registers and medical records on 433 women, 18-60 years of age, diagnosed 1998-2002 with lymph node-positive BC, and considered for adjuvant chemotherapy. CTR-CVT was defined as HT, CAD, HF, or AF after the diagnosis of BC. Follow-up was from the date of BC diagnosis until November 30, 2021, or death. Prevalence of CTR-CVT and all-cause mortality were calculated. Hazard ratios (HR) were determined for factors associated with CTR-CVT.ResultsThe median age was 50 (interquartile range (IQR) 32) years. 910 CTR-CVT events were diagnosed in 311 women with a median of 19.3 (IQR 15,3) years follow-up. The proportions of CTR-CVT events were: HT 281 (64%); CAD 198 (46%); HF 206 (47%); and AF 225 (51%). The cumulative incidence of CTR-CVT was 71.8%, and 50% of all 433 patients developed CTR-CVT within 11.7 years of BC diagnosis (standard deviation (SD) 0.57, 95% confidence interval (CI) 10.6-12.9). Age was a risk factor for CTR-CVT. Anthracycline increased the risk for HF (p=0,001; HR 2,0; 95%CI 1,4-2,8), CAD (p= 0,002; HR 1,7; 95% CI 1,2-2,4), and AF (p=0,013; HR 1,5; 95% CI 1,0-2,0). At the end of the 24-year study period, 227 of the 433 women were alive, and the total cumulative mortality was 47,6%.ConclusionThe prevalence of CTR-CVT and all-cause mortality is high after BC diagnosis and treatment, particularly in older patients and those receiving anthracyclines. These findings and the onset of CTR-CVT support cardio-oncology guidelines recommending initial risk stratification and cardiovascular monitoring during treatment, followed by long-term annual screening for cardiovascular risk factors and CTR-CVT among BC survivors.

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Section: Discussionmentioning

confidence: 99%

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study

et al. 2023

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“…Genetic factors—like a low prevalence of the thrombophilic trait (known as factor V Leiden mutation) and thrombin gene 20210A , low mean levels of fibrinogen, factor VIIc, and factor VIIIc—may contribute to the low prevalence of VTE in Asian population [ 19 ]. However, recent studies show that the incidences of symptomatic DVT and PE are comparable among Asian and Western population [ 5 , 6 ]. Therefore, the reason for the absence of DVT in our study is not clear as it could either be attributed to a low prevalence of DVT in the study population or indicate adequacy of methods used for thromboprophylaxis and risk stratification or underscore a study limitation in terms of assessing the presence of only symptomatic DVT.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies show that incidences of symptomatic deep vein thrombosis (DVT) and PE among Asian colorectal cancer surgery patients are comparable to those in the West [ 5 ]. Likewise the prevalence of PE in cancer patients in India is not as low as originally assumed, and PE is associated with high mortality in these patients [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Observational Study to Determine Rate of Thromboprophylaxis in Oncology Patients Undergoing Abdominal or Pelvic Surgery

Shrikhande

Verma

2021

Indian J Surg Oncol

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Venous thromboembolism (VTE) is common in patients with cancer and is a leading cause of death. In addition to the hypercoagulable state associated with malignancy, cancer-related surgery and subsequent immobilization further increase the risk of VTE. Guidelines suggest extended prophylaxis up to 4 weeks with low-molecular-weight heparin (LMWH) in such patients. This study is conducted to determine the proportion of patients receiving thromboprophylaxis among those undergoing surgery for malignant abdominal or pelvic tumor. This prospective, multicenter, observational study included 300 patients (217 [72.3%] were women). Mean age and duration of cancer were 53.2 and 1.2 years, respectively. A total of 162 (54%) patients received thromboprophylaxis of which only pharmacological in 78 [48.1%], only mechanical in 27 [16.7%], and both pharmacological and mechanical in 57 [35.2%] patients. LMWH (128, 79.0%) and graduated compression stockings (74, 45.7%) were the commonly used modalities. VTE prophylaxis was given in only half of the patients. Physician education to increase adherence to international guidelines is very important. Trial Registration No. CTRI/2013/05/003617.

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“…147 Trastuzumab is being evaluated in combination with concurrent chemoradiation therapy with paclitaxel in patients with MIBC who have undergone TURBT and are not candidates for radical cystectomy. 148 Lapatinib, an oral dual EGFR and Her2 tyrosine kinase inhibitor, is also being studied in combination with chemotherapy for metastatic urothelial carcinoma. 149,150 …”

Section: Biomarker Studies In Mibcmentioning

confidence: 99%

Multimodal management of muscle-invasive bladder cancer

Park¹,

Citrin²,

Agarwal³

et al. 2014

Current Problems in Cancer

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Pulmonary embolism in cancer patients

Abstract: The prevalence of PE and mortality due to PE is high in cancer patients. Risk stratification for venous thromboembolism (VTE) should be done in all cancer patients and thromboprophylaxis should be optimally used.

Cited by 14 publications

References 27 publications

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study

Long-term and real-life incidence of cancer therapy-related cardiovascular toxicity in patients with breast cancer: a Swedish cohort study

A Prospective Observational Study to Determine Rate of Thromboprophylaxis in Oncology Patients Undergoing Abdominal or Pelvic Surgery

Multimodal management of muscle-invasive bladder cancer

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