Pulmonary embolism is a frequent complication in lung cancer patients, with an overall pooled incidence of 3.7% across various clinical settings.
What is the relationship between lung cancer and pulmonary embolism, and what is the role of prophylactic anticoagulant therapy?
This review highlights the high incidence and mortality impact of pulmonary embolism in lung cancer patients, suggesting a benefit for prophylactic anticoagulant therapy, particularly with heparin.
Pulmonary embolism (PE) is gradually considered to be the third most common disease in the vascular disease category. Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males worldwide. Although initially appearing as distinct entities, lung cancer is a great risk factor for the development of PE. Pulmonary embolism is common in lung cancer patients, with a pooled incidence of 3.7%, and unsuspected pulmonary embolism (UPE) is also non-negligible with a rough rate ranging from 29.4% to 63%. Many risk factors of PE have been detected and could be classified into three categories: lung cancer-related, patient-related, and treatment-related factors. Decreased mean survival time could be significantly observed in lung cancer patients with PE or UPE compared to those only, but suspected PE has higher mortality than UPE. Prophylactic anticoagulant therapy benefit might be highest in patients with stage IV non-small cell lung cancer (NSCLC) or limited small cell lung cancer (SCLC), and heparin seems superior to warfarin for thrombotic prophylaxis. Periodically reassessing the risk-benefit ratio of anticoagulant treatment will be an efficient treatment strategy in lung cancer patients with PE.
Li et al. (Mon,) conducted a review in Lung cancer and pulmonary embolism (n=31,294). Pulmonary embolism is a frequent complication in lung cancer patients, with an overall pooled incidence of 3.7% across various clinical settings.