title: Severe haemoptysis in patients with nonsmall cell lung carcinoma.
abstract: Severe haemoptysis due to nonsmall cell lung cancer (NSCLC) is considered a grim condition, and there is still scarce data on its characteristics and outcome, despite new imaging and treatment modalities. This retrospective study sought to describe the clinical characteristics, pathophysiology and outcome of NSCLC-related haemoptysis. We included 125 consecutive patients with severe haemoptysis (>100 mL) at admission, 65 (52%) exhibiting squamous cell carcinoma. Tumour cavitation/necrosis was reported in 26 (21%) patients. 52 patients had received anticancer treatment, but none had received anti-angiogenic agents. Severe haemoptysis was related mainly to the bronchial artery (82%), and major pulmonary artery involvement was rare (6.4%). Interventional radiology was performed in 102 patients. Bleeding cessation was achieved in 108 (87%) out of 125 patients. The overall in-hospital and 1-year survival rates were 69% and 30%, respectively. Performance status (PS) ≥ 2 (OR 3.6, 95% CI 1.3-9.6), advanced stage (OR 8.6, 95% CI 2-37) and mechanical ventilation (OR 13, 95% CI 4.5-36) were independent predictors of in-hospital mortality. Performance status ≥ 2 (hazard ratio (HR) 2.4, 95% CI 1.5-3.7), advanced stage (HR 4, 95% CI 2.1-7.7), cancer progression (HR 2, 95% CI 1.01-2.7) and cavitation/necrosis (HR 1.7, 95% CI 1.21-3.2) were independently associated with 1-year mortality. Management of severe haemoptysis related to NSCLC should be improved, given our observed survival rates after hospital discharge.
authors.affiliation: AP-HP, Hôpital Tenon, Unité de Réanimation Médico-Chirurgicale, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Razazi
authors.affiliation: AP-HP, Hôpital Tenon, Unité de Réanimation Médico-Chirurgicale, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France antoine.parrot@tnn.aphp.fr.
authors.forename: Antoine
authors.initials: A
authors.lastname: Parrot
authors.affiliation: AP-HP, Hôpital Tenon, Service de Radiologie, Pôle Imagerie, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Khalil
authors.affiliation: AP-HP, Hôpital Tenon, Unité de Réanimation Médico-Chirurgicale, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Djibre
authors.affiliation: AP-HP, Hôpital Tenon, Service de Pneumologie - Centre Expert en Oncologie Thoracique, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France AP-HP, Hôpital Tenon, Service de Chirurgie Thoracique, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Gounant
authors.affiliation: AP-HP, Hôpital Tenon, Service de Chirurgie Thoracique, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Jalal
authors.initials: J
authors.lastname: Assouad
authors.affiliation: AP-HP, Hôpital Tenon, Service de Radiologie, Pôle Imagerie, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Marie France
authors.initials: MF
authors.lastname: Carette
authors.affiliation: AP-HP, Hôpital Tenon, Unité de Réanimation Médico-Chirurgicale, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Fartoukh
authors.affiliation: AP-HP, Hôpital Tenon, Service de Pneumologie - Centre Expert en Oncologie Thoracique, Pôle Thorax Voies Aériennes, Groupe Hospitalier des Hôpitaux Universitaires de l'Est Parisien, Paris, France Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cadranel
mesh_terms: D000792:Angiography / Q000379:methods; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001981:Bronchial Arteries / Q000000981:diagnostic imaging*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents