Key result
Concomitant DVT and PE in lung cancer is linked to worse survival than either alone.
Why the study?
Little is known regarding differences in clinical characteristics and predictive factors among different presentations of venous thromboembolism due to lung cancer.
Cohort
p-value: p=.002
In patients with lung cancer, concomitant DVT and PE represents the most severe state with the earliest occurrence and worst survival compared to isolated DVT or PE.
May guide VTE risk stratification in lung cancer; leaves open whether intensified therapy improves survival.
INTRODUCTION: Venous thromboembolism (VTE) because of lung cancer has been sufficiently studied, nevertheless, little is known regarding the discrepancy of clinical characteristics and predictive factors among different presentations of VTE because of lung cancer. OBJECTIVES: This study was designed to investigate the distinction of clinical characteristics and predictive factors among different presentations of VTE because of lung cancer. METHODS: All patients concomitant lung cancer and VTE were stratified into three groups: pulmonary embolism (PE) group in which patients had sole PE, deep vein thrombosis (DVT) group with sole DVT and concomitance group with both PE and DVT. RESULTS: Concomitance of PE and DVT (28.2 days) mostly occurred at the early stage after the diagnosis of lung cancer, by contrast with DVT (63.6 days) which did at the latest stage, whereas PE (36.7 days) generally developed intermediately in between (P = .02). In a Kaplan-Meier analysis, the cumulative survival rate of DVT group was higher than that of concomitance group, whereas the rate of PE group lied in between. (P = .002) The strongest correlated factors with the development of DVT, PE and concomitance were adenocarcinoma (HR 3.27, P = .003), chemotherapy (HR 2.62, P = .005) and D-Dimer (HR 3.88, P < .001), respectively. The strongest correlated factors with the mortality of DVT, PE and concomitance were comorbidity (HR 2.32, P = .003), metastasis (HR 3.12, P < .001), and metastasis (HR 4.29, P < .001), respectively. CONCLUSION: Concomitance of DVT and PE represents the severest state of lung cancer, the earliest occurrence of VTE, and the worst survival rate, whereas DVT stands for the mildest condition of lung cancer and stablest pattern of VTE.
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Guo et al. (2019) conducted a cohort in Lung cancer and venous thromboembolism. Concomitant pulmonary embolism and deep vein thrombosis vs. Sole pulmonary embolism or sole deep vein thrombosis was evaluated on Cumulative survival rate (p=.002). Concomitance of DVT and PE in lung cancer patients was associated with the earliest occurrence of VTE and the worst survival rate compared to DVT or PE alone (P=0.002).
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