Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

Abstract

Objectives Lung 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. Methods We 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. Results Among 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). Conclusions In 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.

Management of venous thromboembolism in patients with lung cancer: a state-of-the-art review

“…Postoperative VTE is not uncommon in patients with lung cancer who undergo surgery. Previous studies reported that the incidence of VTE after lung cancer surgery ranges from 4.5% to 13.9% 10 12 22 37–40. For patients with lung cancer who undergo thoracic surgery, there are some specific risk factors for postoperative VTE development.…”

Incidence of venous thromboembolism and hemorrhage in Chinese patients after pulmonary lobectomy: mechanical prophylaxis or mechanical prophylaxis combined with pharmacological prophylaxis: a randomized controlled trial

“…M e t h o d s t o p r e v e n t V T E i n c l u d e m e c h a n i c a l prophylaxis, which usually uses intermittent pneumatic compression (IPC) and medical elastic stockings (MES), and pharmacological prophylaxis such as low-molecular-weight heparin (LMWH). In Western countries, both mechanical and pharmacological prophylaxis are widely used as standard preventive methods for VTE after routine surgery (9)(10)(11). Widespread overuse of LMWH is likely to translate into a risk of adverse events, including bleeding events.…”