Venous Thromboembolism in Patents With Lung Cancer

Abstract

Lung cancer is the leading cause of death from cancer in Japan. Studies in other countries have reported a venous thromboembolism (VTE) rate of 4%–20% in cancer patients. In this study, we aimed to determine the incidence of VTE in lung cancer patients in Japan and compared the characteristics of patients with and without VTE. In this retrospective cohort study, the clinicopathological characteristics of study patients with and without concomitant VTE were compared. Patients with lung cancer treated at Fukui Prefectural Hospital, Japan from 2008 to 2017. Of the 1471 patients with lung cancer studied, 28 developed VTE. Five patients developed pulmonary thromboembolism (PTE) alone, 9 PTE with concomitant deep vein thrombosis, and 14 deep vein thrombosis alone. Compared with patients in the non-VTE group, the VTE group was significantly younger (mean value ± SD 66.3 ± 10.1 vs. 73.0 ± 10.6 years, p = 0.001), contained significantly more patients with stage IIIb–IV disease (p = 0.002), and had a significantly higher rate of chemotherapy (p < 0.001) and radiation therapy (p = 0.007). There was no significant difference in median survival time from lung cancer diagnosis between the VTE and non-VTE groups. The 1-year mortality rate after VTE diagnosis was 60.7%. Lung cancer was the most frequent cause of death, followed by infection and VTE. Several baseline characteristics differed between patients with and without VTE. The prognosis may worsen after development of VTE, suggesting that lung cancer patients should be carefully monitored for it.

Advances in the Prediction and Risk Assessment of Lung Cancer-Associated Venous Thromboembolism

“…These findings agreed with the data of other studies indicating that most thromboembolic events in patients with lung cancer undergoing chemotherapy occur within 6 months after diagnosis. 3 …”

“…These findings agreed with the data of other studies indicating that most thromboembolic events in patients with lung cancer undergoing chemotherapy occur within 6 months after diagnosis. 3 Therapy-Related Risk Factors Surgery A prospective study investigating blood coagulation in lung cancer patients and benign lung disease patients indicated that both patients with lung lobes in a hypercoagulable state pre-and post-operation were prone to thrombosis. 32 In a retrospective study, 232 patients undergoing lung cancer surgery were investigated in detail, and of these 5.2% developed VTE after 60 days.…”

“…VTE incidence can even be as high as 4–20% in these patients, based on epidemiological investigations. 3 VTE is usually associated with a poor prognosis for individuals with this disease, which increases morbidity, mortality, and medical costs.…”

Analysis of thromboembolic events in patients with non-small cell lung cancer who received adjuvant chemotherapy: single-center real-world data

“…Multiple causes, such as an overexpression of tissue factor, thrombocytosis, leukocytosis, anemia, infection, old age, circulatory stasis, and immobilization, may contribute to the occurrence of TEE in patients with cancer 10 , 23 – 26 . Furthermore, the administration of anti-cancer drugs, especially platinum compounds, the essential agents for adjuvant chemotherapy for NSCLC, is associated with the risk of TEE 9 – 12 , 18 , 25 , 26 . Although the mechanisms of platinum-induced hypercoagulability are not entirely clear, several reports have suggested possible pathophysiologic processes such as vascular endothelial cell damage and necrosis, platelet activation and aggregation, and increased procoagulant activity 11 , 27 , 28 .…”

“…In addition, the risk of TEE can increase with the administration of chemotherapy 9 – 11 . TEEs have been reported in patients with NSCLC receiving palliative chemotherapy or those with small cell lung cancer (SCLC) in several studies 9 , 12 – 20 . However, there were very few reports about TEEs in NSCLC patients who underwent adjuvant chemotherapy.…”