title: Unsuspected pulmonary emboli in lung cancer patients: the impact on survival and the significance of anticoagulation therapy.
abstract: 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.
authors.affiliation: 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.
authors.forename: Jong-Mu
authors.initials: JM
authors.lastname: Sun
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Kim
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Park
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Ahn
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
authors.forename: Myung-Ju
authors.initials: MJ
authors.lastname: Ahn
mesh_terms: 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
chemical_list: D000925:Anticoagulants