Risk and Prognosis of Cancer After Lower Limb Arterial Thrombosis

Sundbøll, Jens; Veres, Katalin; Horváth‐Puhó, Erzsébet; Adelborg, Kasper; Sørensen, Henrik Toft

doi:10.1161/circulationaha.117.032617

Cited by 34 publications

(23 citation statements)

References 24 publications

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“…Sundboll and colleagues examined cancer risk and prognosis of cancer in patients with lower limb PAD and arterial thrombosis. They reported that the risk of any cancer was 2.5% after 6 months of follow-up, which increased to 17.9% after 20 years [ 65 ]. Since cigarette smoking happens to be the common risk factor for many cancers, such as cancer of lung, head and neck, esophagus, stomach, liver, colon, pancreas, kidney, bladder, ovary, uterine cervix and myeloid leukemia, the association of PAD can be an indirect evidence of presence of cancer and overall influence on mortality.…”

Section: Discussionmentioning

confidence: 99%

Association Between Obesity and Cancer Mortality: An Internal Medicine Outpatient Clinic Perspective

et al. 2021

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Background: Obesity is one of the leading preventable causes of cancer that has a causal relationship with cancers of esophagus, breast and colon. Paradoxically, there are studies demonstrating that obesity is associated with improved survival in cancer patients. The aim of our study was to investigate the association of obesity and cancer mortality in adult patients.Methods: Retrospective medical record review of 784 adult patients was performed who had a diagnosis of cancer and who were seen in

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Section: Discussionmentioning

confidence: 99%

Association Between Obesity and Cancer Mortality: An Internal Medicine Outpatient Clinic Perspective

et al. 2021

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“…Conversely, the risk of cancer in patients with arterial embolism was 2.5% after 6 months and 17.9% after 20 years of follow-up. 9 The development of both venous and arterial thromboembolism should raise the suspicion of underlying pathology even more, but descriptive data on the incidence rate of malignancy in this situation are lacking.…”

Section: Discussionmentioning

confidence: 99%

Non-bacterial thrombotic endocarditis manifested by ventricular fibrillation in a patient with low grade ovarian carcinoma: case report and literature review

Kuipers¹,

Berghuis

Ogilvie

et al. 2021

European Heart Journal - Case Reports

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Background Non-bacterial thrombotic endocarditis (NBTE) is a rare form of endocarditis notably described in patients with advanced malignancy and auto-immune diseases. It is characterized by the formation of sterile, fibrin-containing vegetations on cardiac endothelium, in the absence of positive blood cultures. It is predominantly located on the mitral- and aortic valve (AV). Vegetations in NBTE are prone to embolize. Trousseau syndrome (TS) is defined as unexplained thrombotic events that precede the diagnosis of malignancy. Case summary A 49-year-old pre-menopausal woman with a history of visual disturbances, recurrent deep vein thrombosis (DVT) with concurrent pulmonary emboli (PE), and uterine myomas with dysfunctional uterine bleeding was resuscitated for ventricular fibrillation. While echocardiography revealed vegetations on the AV, blood cultures remained negative. Additional work-up for the aetiology of sterile vegetations revealed a low-grade ovarian carcinoma. Cardiac analysis showed evidence of myocardial infarction in the absence of coronary atherosclerosis as a cause for ventricular fibrillation. Discussion Unexplained thrombotic events (venous, arterial, or both) warrant further investigation, e.g., with regard to TS. NBTE is a potential source of thromboembolism in TS and a rare ante-mortem finding, which prompts additional investigation of the underlying cause. In our patient, a triad of (suspected) (i) arterial/systemic embolization (i.e. visual disturbances, splenic infarction, coronary embolism), (ii) peripheral thrombophlebitis/hypercoagulability (i.e. DVT and PE), and (iii) malignancy (i.e. gynaecological abnormalities) raised suspicion of NBTE in the setting of TS. Early diagnosis and treatment of NBTE is of importance due to the high incidence of embolization, with possible fatal outcome.

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“…Arterial thromboembolism was once thought to be quite rare, but the reported rate varies between 11.7% of critical limb ischemia patients 5 and 16% of all acute limb ischemia with occult malignancy. 6 It can present with cardiac, splenic, and renal infarcts, as well as ischemic strokes 7 and vessel occlusion in either upper or lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Arterial Embolism in Malignancy: The Role of Surgery

Harnarayan¹,

Islam²,

Naraynsingh

2021

TCRM

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Background Peripheral arterial embolism from malignant disease is uncommon and a rare cause of limb ischemia. In the acute setting, patients can present with severe ischemia of either the upper or lower limb, and urgent surgical intervention is often required to avoid severe debilitation and limb loss. Patients Our case series comprised three patients who presented with upper and lower limb ischemia and were found to have concomitant malignancy. All three patients were female, with a median age of 54.3 years, and none of the patients was on active chemotherapy. One presented with stage IIb uterine carcinoma, one with stage IIIb ovarian carcinoma, and the other with stage IIIb cervical carcinoma. These patients were referred for vascular management, with two being acute and the other acute on chronic. Results Of the three patients, two presented with acute limb ischemia and underwent arterial thrombectomy, one of the upper and the other the lower limb. The third patient, with acute-on-chronic upper limb ischemia, was treated conservatively with intravenous heparin followed by oral anticoagulation. All three had limb salvage and survival outcome at 1 year post-treatment. Conclusion In this small series, surgical intervention in two patients and conservative management in the other patient led to limb salvage with a reasonably good quality of life. Even though the long-term survival for patients with malignant disease is generally poor, surgical intervention can achieve limb salvage with a reasonably good quality of life.

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Risk and Prognosis of Cancer After Lower Limb Arterial Thrombosis

Abstract: Lower limb arterial thrombosis was a marker of occult cancer, especially lung cancer, and was an adverse prognostic factor for mortality in common cancers.

Cited by 34 publications

References 24 publications

Association Between Obesity and Cancer Mortality: An Internal Medicine Outpatient Clinic Perspective

Association Between Obesity and Cancer Mortality: An Internal Medicine Outpatient Clinic Perspective

Non-bacterial thrombotic endocarditis manifested by ventricular fibrillation in a patient with low grade ovarian carcinoma: case report and literature review

Arterial Embolism in Malignancy: The Role of Surgery

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