Cargando…
Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism
SIMPLE SUMMARY: Cancer is a widely heterogeneous disease, and the natural history of patients with cancer-associated thrombosis may differ according to the cancer site. Lung cancer is the most common malignancy, and a leading cause of death. A number of studies in the literature suggest that patient...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9454710/ https://www.ncbi.nlm.nih.gov/pubmed/36077663 http://dx.doi.org/10.3390/cancers14174127 |
_version_ | 1784785414315311104 |
---|---|
author | Ruiz-Artacho, Pedro Lecumberri, Ramón Trujillo-Santos, Javier Font, Carme López-Núñez, Juan J. Peris, María Luisa Díaz Pedroche, Carmen Lobo, José Luis López Jiménez, Luciano López Reyes, Raquel Jara Palomares, Luis Pedrajas, José María Mahé, Isabelle Monreal, Manuel |
author_facet | Ruiz-Artacho, Pedro Lecumberri, Ramón Trujillo-Santos, Javier Font, Carme López-Núñez, Juan J. Peris, María Luisa Díaz Pedroche, Carmen Lobo, José Luis López Jiménez, Luciano López Reyes, Raquel Jara Palomares, Luis Pedrajas, José María Mahé, Isabelle Monreal, Manuel |
author_sort | Ruiz-Artacho, Pedro |
collection | PubMed |
description | SIMPLE SUMMARY: Cancer is a widely heterogeneous disease, and the natural history of patients with cancer-associated thrombosis may differ according to the cancer site. Lung cancer is the most common malignancy, and a leading cause of death. A number of studies in the literature suggest that patients with adenocarcinoma may have a worse outcome than those with squamous or other types of lung cancer. The aim of the current study was to assess the potential impact of lung cancer histology on the incidence rates of VTE recurrences, major bleeding, or death appearing during the course of anticoagulation, in patients with lung cancer and VTE. Our findings, obtained from a large series of consecutive patients with lung cancer and VTE (482 patients), reveal important differences between patients with adenocarcinoma vs. other histologies in their outcomes during anticoagulation. This might likely help to design better therapeutic strategies for patients with lung cancer. ABSTRACT: Background: In patients with lung cancer and venous thromboembolism (VTE), the influence of cancer histology on outcome has not been consistently evaluated. Methods: We used the RIETE registry (Registro Informatizado Enfermedad TromboEmbólica) to compare the clinical characteristics and outcomes during anticoagulation in patients with lung cancer and VTE, according to the histology of lung cancer. Results: As of April 2022, there were 482 patients with lung cancer and VTE: adenocarcinoma 293 (61%), squamous 98 (20%), small-cell 44 (9.1%), other 47 (9.8%). The index VTE was diagnosed later in patients with squamous cancer than in those with adenocarcinoma (median, 5 vs. 2 months). In 50% of patients with adenocarcinoma, the VTE appeared within the first 90 days since cancer diagnosis. During anticoagulation (median 106 days, IQR: 45–214), 14 patients developed VTE recurrences, 15 suffered major bleeding, and 218 died: fatal pulmonary embolism 10, fatal bleeding 2. The rate of VTE recurrences was higher than the rate of major bleeding in patients with adenocarcinoma (11 vs. 6 events), and lower in those with other cancer types (3 vs. 9 events). On multivariable analysis, patients with adenocarcinoma had a non-significantly higher risk for VTE recurrences (hazard ratio [HR]: 3.79; 95%CI: 0.76–18.8), a lower risk of major bleeding (HR: 0.29; 95%CI: 0.09–0.95), and a similar risk of mortality (HR: 1.02; 95%CI: 0.76–1.36) than patients with other types of lung cancer. Conclusions: In patients with lung adenocarcinoma, the rate of VTE recurrences outweighed the rate of major bleeding. In patients with other lung cancers, it was the opposite. |
format | Online Article Text |
id | pubmed-9454710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94547102022-09-09 Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism Ruiz-Artacho, Pedro Lecumberri, Ramón Trujillo-Santos, Javier Font, Carme López-Núñez, Juan J. Peris, María Luisa Díaz Pedroche, Carmen Lobo, José Luis López Jiménez, Luciano López Reyes, Raquel Jara Palomares, Luis Pedrajas, José María Mahé, Isabelle Monreal, Manuel Cancers (Basel) Article SIMPLE SUMMARY: Cancer is a widely heterogeneous disease, and the natural history of patients with cancer-associated thrombosis may differ according to the cancer site. Lung cancer is the most common malignancy, and a leading cause of death. A number of studies in the literature suggest that patients with adenocarcinoma may have a worse outcome than those with squamous or other types of lung cancer. The aim of the current study was to assess the potential impact of lung cancer histology on the incidence rates of VTE recurrences, major bleeding, or death appearing during the course of anticoagulation, in patients with lung cancer and VTE. Our findings, obtained from a large series of consecutive patients with lung cancer and VTE (482 patients), reveal important differences between patients with adenocarcinoma vs. other histologies in their outcomes during anticoagulation. This might likely help to design better therapeutic strategies for patients with lung cancer. ABSTRACT: Background: In patients with lung cancer and venous thromboembolism (VTE), the influence of cancer histology on outcome has not been consistently evaluated. Methods: We used the RIETE registry (Registro Informatizado Enfermedad TromboEmbólica) to compare the clinical characteristics and outcomes during anticoagulation in patients with lung cancer and VTE, according to the histology of lung cancer. Results: As of April 2022, there were 482 patients with lung cancer and VTE: adenocarcinoma 293 (61%), squamous 98 (20%), small-cell 44 (9.1%), other 47 (9.8%). The index VTE was diagnosed later in patients with squamous cancer than in those with adenocarcinoma (median, 5 vs. 2 months). In 50% of patients with adenocarcinoma, the VTE appeared within the first 90 days since cancer diagnosis. During anticoagulation (median 106 days, IQR: 45–214), 14 patients developed VTE recurrences, 15 suffered major bleeding, and 218 died: fatal pulmonary embolism 10, fatal bleeding 2. The rate of VTE recurrences was higher than the rate of major bleeding in patients with adenocarcinoma (11 vs. 6 events), and lower in those with other cancer types (3 vs. 9 events). On multivariable analysis, patients with adenocarcinoma had a non-significantly higher risk for VTE recurrences (hazard ratio [HR]: 3.79; 95%CI: 0.76–18.8), a lower risk of major bleeding (HR: 0.29; 95%CI: 0.09–0.95), and a similar risk of mortality (HR: 1.02; 95%CI: 0.76–1.36) than patients with other types of lung cancer. Conclusions: In patients with lung adenocarcinoma, the rate of VTE recurrences outweighed the rate of major bleeding. In patients with other lung cancers, it was the opposite. MDPI 2022-08-26 /pmc/articles/PMC9454710/ /pubmed/36077663 http://dx.doi.org/10.3390/cancers14174127 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Ruiz-Artacho, Pedro Lecumberri, Ramón Trujillo-Santos, Javier Font, Carme López-Núñez, Juan J. Peris, María Luisa Díaz Pedroche, Carmen Lobo, José Luis López Jiménez, Luciano López Reyes, Raquel Jara Palomares, Luis Pedrajas, José María Mahé, Isabelle Monreal, Manuel Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title | Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title_full | Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title_fullStr | Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title_full_unstemmed | Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title_short | Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism |
title_sort | cancer histology and natural history of patients with lung cancer and venous thromboembolism |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9454710/ https://www.ncbi.nlm.nih.gov/pubmed/36077663 http://dx.doi.org/10.3390/cancers14174127 |
work_keys_str_mv | AT ruizartachopedro cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT lecumberriramon cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT trujillosantosjavier cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT fontcarme cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT lopeznunezjuanj cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT perismarialuisa cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT diazpedrochecarmen cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT lobojoseluis cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT lopezjimenezluciano cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT lopezreyesraquel cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT jarapalomaresluis cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT pedrajasjosemaria cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT maheisabelle cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT monrealmanuel cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism AT cancerhistologyandnaturalhistoryofpatientswithlungcancerandvenousthromboembolism |