16a10b7e7ecab3a5d715f3b75627e7aa pmc_9454710.pdf 9f243b8d8f0fd72701f0b92bb91b85089f5c6f92 pmc_9454710.pdf 0fb4a8cfc711350515e9a80c5a010d363fc7869d632a03983d448a7efddc316c pmc_9454710.pdf Title: Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism Subject: 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. Keywords: venous thrombolism; lung cancer; adenocarcinoma lung cancer; cancer associatedthrombosis; histology Author: Pedro Ruiz-Artacho, Ramón Lecumberri, Javier Trujillo-Santos, Carme Font, Juan J. López-Núñez, María Luisa Peris, Carmen Díaz Pedroche, José Luis Lobo, Luciano López Jiménez, Raquel López Reyes, Luis Jara Palomares, José María Pedrajas, Isabelle Mahé, Manuel Monreal and The RIETE Investigators Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Aug 26 12:08:42 2022 CEST ModDate: Fri Aug 26 12:11:32 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1716215 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UGJLIL+VnURWPalladioL Type 1 Custom yes yes no 10 0 EZZKTW+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 MJDRWY+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 UDWPPT+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 IPTOFW+URWPalladioL-BoldItal Type 1 Custom yes yes no 28 0 DIMMOC+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 TNBSFT+CMSY10 Type 1 Builtin yes yes no 76 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 83 0 CIDFont+F3 CID TrueType Identity-H yes no yes 98 0 CIDFont+F1 CID TrueType Identity-H yes no yes 106 0 CIDFont+F2 CID TrueType Identity-H yes no yes 114 0 CIDFont+F6 CID TrueType Identity-H yes no yes 122 0 CIDFont+F7 CID TrueType Identity-H yes no yes 130 0 CIDFont+F3 CID TrueType Identity-H yes no yes 140 0 CIDFont+F1 CID TrueType Identity-H yes no yes 148 0 CIDFont+F2 CID TrueType Identity-H yes no yes 156 0 CIDFont+F6 CID TrueType Identity-H yes no yes 164 0 CIDFont+F7 CID TrueType Identity-H yes no yes 172 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-08-23 02:26:19 CEST RepresentationInformation: pmc_9454710.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-08-05 02:20:37 CEST Size: 1716215 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 291 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Inclusion Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Appendix A Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism Author: Pedro Ruiz-Artacho, Ramón Lecumberri, Javier Trujillo-Santos, Carme Font, Juan J. López-Núñez, María Luisa Peris, Carmen Díaz Pedroche, José Luis Lobo, Luciano López Jiménez, Raquel López Reyes, Luis Jara Palomares, José María Pedrajas, Isabelle Mahé, Manuel Monreal and The RIETE Investigators Subject: 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. 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