TY - JOUR
T1 - Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism
AU - Ruiz-Artacho, Pedro
AU - Lecumberri, Ramón
AU - Trujillo-Santos, Javier
AU - Font, Carme
AU - López-Núñez, Juan J.
AU - Peris, María Luisa
AU - Pedroche, Carmen Díaz
AU - Lobo, José Luis
AU - Jiménez, Luciano López
AU - Reyes, Raquel López
AU - Palomares, Luis Jara
AU - Pedrajas, José María
AU - Mahé, Isabelle
AU - Monreal, Manuel
AU - The RIETE Investigators
AU - Adarraga, M. D.
A2 - Prandoni, Paolo
A2 - Brenner, Benjamin
A2 - Farge-Bancel, Dominique
A2 - Barba, Raquel
A2 - Di Micco, Pierpaolo
A2 - Bertoletti, Laurent
A2 - Schellong, Sebastian
A2 - Tzoran, Inna
A2 - Reis, Abilio
A2 - Bosevski, Marijan
A2 - Bounameaux, Henri
A2 - Malý, Radovan
A2 - Verhamme, Peter
A2 - Caprini, Joseph A.
A2 - My Bui, Hanh
A2 - Agudo, P.
A2 - Alonso-Carrillo, J.
A2 - Amado, C.
A2 - Arcelus, J. I.
A2 - Ballaz, A.
A2 - Barba, R.
A2 - Barrón, M.
A2 - Barrón-Andrés, B.
A2 - Beddar-Chaib, F.
A2 - Blanco-Molina, A.
A2 - Cañas, I.
A2 - Carriel, J.
A2 - Casado, I.
A2 - Cerdá, P.
A2 - Chasco, L.
A2 - Criado, J.
A2 - de Ancos, C.
A2 - de Miguel, J.
A2 - Kigitovica, D.
A2 - Skride, A.
N1 - Link to the RIETE Registry participating centers
https://www.riete.org/info/centros_participantes/index.php
Publisher Copyright:
© 2022 by the authors.
PY - 2022/9
Y1 - 2022/9
N2 - Background: In patients with lung cancer and venous thromboembolism (VTE), the influence of cancer histology on outcome has not been consistently evaluated. Methods: We used the RIETE registry (Registro Informatizado Enfermedad TromboEmbólica) to compare the clinical characteristics and outcomes during anticoagulation in patients with lung cancer and VTE, according to the histology of lung cancer. Results: As of April 2022, there were 482 patients with lung cancer and VTE: adenocarcinoma 293 (61%), squamous 98 (20%), small-cell 44 (9.1%), other 47 (9.8%). The index VTE was diagnosed later in patients with squamous cancer than in those with adenocarcinoma (median, 5 vs. 2 months). In 50% of patients with adenocarcinoma, the VTE appeared within the first 90 days since cancer diagnosis. During anticoagulation (median 106 days, IQR: 45–214), 14 patients developed VTE recurrences, 15 suffered major bleeding, and 218 died: fatal pulmonary embolism 10, fatal bleeding 2. The rate of VTE recurrences was higher than the rate of major bleeding in patients with adenocarcinoma (11 vs. 6 events), and lower in those with other cancer types (3 vs. 9 events). On multivariable analysis, patients with adenocarcinoma had a non-significantly higher risk for VTE recurrences (hazard ratio [HR]: 3.79; 95%CI: 0.76–18.8), a lower risk of major bleeding (HR: 0.29; 95%CI: 0.09–0.95), and a similar risk of mortality (HR: 1.02; 95%CI: 0.76–1.36) than patients with other types of lung cancer. Conclusions: In patients with lung adenocarcinoma, the rate of VTE recurrences outweighed the rate of major bleeding. In patients with other lung cancers, it was the opposite.
AB - Background: In patients with lung cancer and venous thromboembolism (VTE), the influence of cancer histology on outcome has not been consistently evaluated. Methods: We used the RIETE registry (Registro Informatizado Enfermedad TromboEmbólica) to compare the clinical characteristics and outcomes during anticoagulation in patients with lung cancer and VTE, according to the histology of lung cancer. Results: As of April 2022, there were 482 patients with lung cancer and VTE: adenocarcinoma 293 (61%), squamous 98 (20%), small-cell 44 (9.1%), other 47 (9.8%). The index VTE was diagnosed later in patients with squamous cancer than in those with adenocarcinoma (median, 5 vs. 2 months). In 50% of patients with adenocarcinoma, the VTE appeared within the first 90 days since cancer diagnosis. During anticoagulation (median 106 days, IQR: 45–214), 14 patients developed VTE recurrences, 15 suffered major bleeding, and 218 died: fatal pulmonary embolism 10, fatal bleeding 2. The rate of VTE recurrences was higher than the rate of major bleeding in patients with adenocarcinoma (11 vs. 6 events), and lower in those with other cancer types (3 vs. 9 events). On multivariable analysis, patients with adenocarcinoma had a non-significantly higher risk for VTE recurrences (hazard ratio [HR]: 3.79; 95%CI: 0.76–18.8), a lower risk of major bleeding (HR: 0.29; 95%CI: 0.09–0.95), and a similar risk of mortality (HR: 1.02; 95%CI: 0.76–1.36) than patients with other types of lung cancer. Conclusions: In patients with lung adenocarcinoma, the rate of VTE recurrences outweighed the rate of major bleeding. In patients with other lung cancers, it was the opposite.
KW - adenocarcinoma lung cancer
KW - cancer associated thrombosis
KW - histology
KW - lung cancer
KW - venous thrombolism
UR - http://www.scopus.com/inward/record.url?scp=85138059181&partnerID=8YFLogxK
U2 - 10.3390/cancers14174127
DO - 10.3390/cancers14174127
M3 - Article
AN - SCOPUS:85138059181
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 17
M1 - 4127
ER -