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March 20, 2023Cancers27 citationsOpen Access

Lung Cancer as a Leading Cause among Paraneoplastic Non-Bacterial Thrombotic Endocarditis: A Meta-Analysis of Individual Patients’ Data

MRMohamed RahoumaSKSherif KhairallahADAnas Dabsha

Key Result

Lung cancer was the most common tumor site associated with non-bacterial thrombotic endocarditis, accounting for 29% of cases (95% CI 0.21-0.37; p<0.001).

Study Design

Type

Meta-Analysis (n=144)

Structured PICO

P
Population
144 patients with cancer-associated non-bacterial thrombotic endocarditis (NBTE) pooled from 121 studies.
O
Outcome
Annual trend in premortem diagnosis, differences in characteristics, and overall survivalhard clinical

Cancer-associated non-bacterial thrombotic endocarditis is most frequently associated with lung cancer and advanced metastatic disease, carrying a dismal prognosis with a median survival of 1.3 months.

Main Result

p-value: p=<0.001

Abstract

Hypercoagulability is strongly associated with cancer and may result in non-bacterial thrombotic endocarditis (NBTE). The aim of our meta-analysis was to explore the demographics and characteristics of this condition in cancer. Databases were systematically searched. The outcomes were to identify the annual trend in premortem diagnosis among the entire cohort and different subgroups and to identify differences in characteristics and survival in the considered population. A total of 121 studies with 144 patients were included. The proportion of marantic endocarditis associated with lung cancer was 0.29 (95% CI, 0.21–0.37; p < 0.001), that associated with pancreatic cancer was 0.19 (95% CI, 0.13–0.27; p < 0.001), that associated with advanced cancer stage (metastasis) was 0.69 (95% CI, 0.61–0.76; p < 0.001), and that associated with adenocarcinoma was 0.65 (95% CI, 0.56–0.72; p < 0.001). Median and 6-month overall survival (OS) were 1.3 months and 32.3%, respectively, with 6-month OS of 20.8% vs. 37.0% in lung vs. other cancers, respectively (p = 0.06) and 42.9% vs. 31.1% among those who underwent intervention vs. those who did not (p = 0.07). Cases discovered in recent years had better survival (HR = 0.98 (95% CI, 0.96–0.99; p = 0.003). While cancer-associated NBTE is a rare entity, lung cancers were the most common tumor site and are frequently associated with more advanced and metastatic cancer stages. The prognosis is dismal, especially among lung cancers.

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Cite This Study

Rahouma et al. (2023) conducted a meta-analysis in Paraneoplastic Non-Bacterial Thrombotic Endocarditis (n=144). Lung cancer vs. Other cancers was evaluated on Proportion of marantic endocarditis associated with lung cancer (95% CI 0.21-0.37, p=<0.001). Lung cancer was the most common tumor site associated with non-bacterial thrombotic endocarditis, accounting for 29% of cases (95% CI 0.21-0.37; p<0.001).

synapsesocial.com/papers/6a0e4d6eb60a7411ea8911ddhttps://doi.org/10.3390/cancers15061848
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