Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism.

Fecha de publicación: 26/08/2022 Fecha Ahead of Print: 26/08/2022

Autores de IIS La Fe

Raquel López Reyes

Autor

Participantes ajenos a IIS La Fe

Ruiz-Artacho, Pedro
Lecumberri, Ramon
Trujillo-Santos, Javier
Font, Carme
Lopez-Nunez, Juan J.
Peris ML
Diaz Pedroche, Carmen
Lobo JL
Lopez Jimenez, Luciano
Jara Palomares, Luis
Pedrajas JM
Mahe, Isabelle
Monreal, Manuel
The Riete Investigators

Grupos

Neumología

Leader

Miguel Ángel Martínez García

Abstract

Simple Summary Cancer is a widely heterogeneous disease, and the natural history of patients with cancer-associated thrombosis may differ according to the cancer site. Lung cancer is the most common malignancy, and a leading cause of death. A number of studies in the literature suggest that patients with adenocarcinoma may have a worse outcome than those with squamous or other types of lung cancer. The aim of the current study was to assess the potential impact of lung cancer histology on the incidence rates of VTE recurrences, major bleeding, or death appearing during the course of anticoagulation, in patients with lung cancer and VTE. Our findings, obtained from a large series of consecutive patients with lung cancer and VTE (482 patients), reveal important differences between patients with adenocarcinoma vs. other histologies in their outcomes during anticoagulation. This might likely help to design better therapeutic strategies for patients with lung cancer. 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 TromboEmbolica) 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.

Datos de la publicación

ISSN/ISSNe:: 2072-6694, 2072-6694
Tipo:: Article
Páginas:: -
DOI:: 10.3390/cancers14174127
Factor de Impacto:: 1,349 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Ruiz-Artacho, Pedro:: Department of Internal Medicine, Clínica Universidad de Navarra, 28027 Madrid, Spain

Interdisciplinar Teragnosis and Radiosomics Research Group (INTRA-Madrid), Universidad de Navarra, 28027 Madrid, Spain

CIBER Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
Lecumberri, Ramon:: Hematology Service, Clínica Universidad de Navarra, 31008 Pamplona, Spain

CIBERCV, Instituto de Salud Carlos III, 28220 Madrid, Spain
Trujillo-Santos, Javier:: Department of Internal Medicine, Hospital General Universitario Santa Lucía, Universidad Católica de Murcia, 30107 Murcia, Spain
Font, Carme:: Department of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain
Lopez-Nunez, Juan J.:: Department of Internal Medicine, Hospital Germans Trias i Pujol, 08916 Badalona, Spain

Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain

Institut de Recerca Germans Trias i Pujol, 08916 Badalona, Spain
Peris ML:: Department of Internal Medicine, Consorcio Hospitalario Provincial de Castellón, 12002 Castellon, Spain

Medicine Department, CEU Cardenal Herrera University, 46115 Valencia, Spain
Diaz Pedroche, Carmen:: Department of Internal Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
Lobo JL:: Department of Pneumonology, Hospital Universitario Araba, 01009 Vitoria-Gasteiz, Spain
Lopez Jimenez, Luciano:: Department of Internal Medicine, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
Lopez Reyes, Raquel:: Department of Pneumonology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
Jara Palomares, Luis:: Department of Pneumonology, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Pedrajas JM:: Department of Internal Medicine, Hospital Clínico San Carlos, 28040 Madrid, Spain
Mahe, Isabelle:: Department of Internal Medicine, Hôpital Louis Mourier, Colombes (APHP), University Paris 7, 75013 Paris, France
Monreal, Manuel:: CIBER Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain

Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM-Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain