Key result
Among oncology patients with pulmonary embolism, 40% of diagnosed PEs were incidental and 60% were symptomatic, with incidental PE being more common in patients with metastatic disease.
Observational (n=111)
Absolute Event Rate: 40% vs 60%
Forty percent of pulmonary embolisms in medical oncology patients are diagnosed incidentally on staging scans, highlighting a high burden of asymptomatic VTE particularly in metastatic disease.
May warrant attention to incidental PE on oncology staging scans; leaves open optimal management in metastatic disease.
AIM: To determine the incidence of symptomatic versus incidental pulmonary embolism (PE) in oncology patients, characterize the nature and extent of incidental PE and the factors contributing to diagnosis. METHODS: Specialized web search engine was used to identify oncology patients with positive imaging studies for PE. PE identified at staging CT scans were classified as incidental PEs, whereas PE diagnosed by CTPA/VQ scan were classified as symptomatic PEs. RESULTS: A total of 111 patients with PE were identified over the period of three years. Of these, 67 (60%) patients had symptomatic whereas 44 (40%) patients had incidental PE. Most PEs were segmental and non-occlusive irrespective of the type of PE or stage of the disease. Incidence of PE was equal with/without chemotherapy. Platinum-based chemotherapy was more commonly associated with PE. Most patients received anticoagulation irrespective of type of PE. CONCLUSION: Forty percent of the diagnosed PEs were incidental, more common in the metastatic group. This may be due to the increased frequency of staging scans performed in patients with metastatic disease, as well as the inherent disease biology of metastatic compared with localized disease. Further prospective analysis of survival by PE subtype and optimal length of anticoagulation in incidental PE is warranted.
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Thaker et al. (2016) conducted an observational in Oncology patients with pulmonary embolism (n=111). Incidental pulmonary embolism vs. Symptomatic pulmonary embolism was evaluated on Incidence of symptomatic versus incidental pulmonary embolism. Among oncology patients with pulmonary embolism, 40% of diagnosed PEs were incidental and 60% were symptomatic, with incidental PE being more common in patients with metastatic disease.
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