Key result
Incidental pulmonary embolism in cancer patients is associated with adverse survival and recurrent venous thromboembolism rates comparable to those with symptomatic pulmonary embolism.
Why the study?
Does incidental pulmonary embolism in cancer patients have similar prognostic implications (recurrent VTE and mortality) as symptomatic pulmonary embolism?
Does incidental pulmonary embolism in cancer patients have similar prognostic implications (recurrent VTE and mortality) as symptomatic pulmonary embolism?
Incidental pulmonary embolism in cancer patients carries a similar risk of recurrent VTE and mortality as symptomatic PE, supporting the consensus to treat both groups similarly with anticoagulation.
Suggests equivalent anticoagulation for incidental and symptomatic PE in cancer; leaves open confirmation by prospective trials.
PURPOSE OF REVIEW: With improvements in the quality of computed tomography (CT) examinations, pulmonary embolism is increasingly being detected incidentally in oncology patients undergoing routine cancer staging CT scans. The purpose of this review is to update current evidence on the prognosis of cancer patients diagnosed with incidental pulmonary embolism. RECENT FINDINGS: Several recent observational studies have shed some light on the prognostic implications of diagnosing incidental pulmonary embolism in cancer patients. In general, anticoagulant treatment is initiated in these patients. Even during treatment, recurrent venous thromboembolic events may occur with a frequency that is comparable to cancer patients who have symptomatic pulmonary embolism. It has been demonstrated that the diagnosis of incidental pulmonary embolism is associated with adverse survival in cancer patients, and the long-term mortality rate in incidental pulmonary embolism patients seems to approach that of symptomatic pulmonary embolism patients. SUMMARY: Overall, the body of literature on patients with incidental pulmonary embolism is sparse and does not allow firm recommendations on the therapeutic approach to these patients. Yet, in the absence of data on the natural clinical course of these patients, and the presence of cohort studies suggesting that incidental pulmonary embolism may impact recurrent venous thromboembolism and mortality, current consensus is to treat these patients in the same manner as symptomatic patients.
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Exter et al. (2012) conducted a review in Incidental pulmonary embolism in patients with malignancy. Anticoagulant treatment vs. Symptomatic pulmonary embolism was evaluated on Recurrent venous thromboembolic events and mortality. Incidental pulmonary embolism in cancer patients is associated with adverse survival and recurrent venous thromboembolism rates comparable to those with symptomatic pulmonary embolism.
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