Unsuspected pulmonary emboli in lung cancer patients: the impact on survival and the significance of anticoagulation therapy.
BACKGROUND
Many pulmonary emboli (PE) are detected unsuspectedly in lung cancer patients. The purpose of our study was to retrospectively evaluate the role of anticoagulation therapy for unsuspected PE in lung cancer patients. We also aimed to evaluate risk factors associated with the development of PE as well as the prognostic power of PE in lung cancer patients.


METHODS
The Samsung Medical Information System was used to evaluate predictors and prognosis of PE in lung cancer patients. We found patients with PE using the Radiation Interpretation Registry and reviewed their medical records.


RESULTS
Among 8014 lung cancer patients, PE developed in 180 patients (cumulative incidence rates=2.2%). Metastasis and prior history of chemotherapy were significant predictors of the development of PE. Pulmonary embolism detected within 3 months after diagnosis of lung cancer was a significant poor prognostic factor (hazard ratio [HR], 1.5; 95% CI, 1.1-2.0) in the complete lung cancer cohort. One hundred thirteen (63%) out of total 180 PE patients were incidentally found to have PE. Among the 113 patients with unsuspected PE, 62 patients (55%) did not receive anticoagulation therapy, and died sooner than those who received anticoagulation therapy for unsuspected PE (HR, 4.1; 95% CI, 2.3-7.6).


CONCLUSIONS
Anticoagulation therapy for unsuspected PE is associated with increased overall survival in lung cancer patients.
Sun
Jong-Mu
JM
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, 135-710 Seoul, Republic of Korea.
Kim
Tae Sung
TS
Lee
Jeeyun
J
Park
Yeon Hee
YH
Ahn
Jin Seok
JS
Kim
Hojoong
H
Kwon
O Jung
OJ
Lee
Kyung Soo
KS
Park
Keunchil
K
Ahn
Myung-Ju
MJ
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D008297:Male; D009362:Neoplasm Metastasis; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate
D000925:Anticoagulants