Cancer Histology and Natural History of Patients with Lung Cancer and Venous Thromboembolism
Ruiz-Artacho, Pedro (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Lecumberri, Ramón (Instituto de Salud Carlos III)
Trujillo-Santos, Javier (Hospital General Universitario Santa Lucía (Cartagena, Múrcia))
Font, Carme (Hospital Clínic i Provincial de Barcelona)
López Núñez, Juan José (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Peris, María Luisa (Consorci Hospitalari Provincial de Castelló)
Díaz-Pedroche, Carmen (Hospital Universitario 12 de Octubre (Madrid))
Lobo, José Luis (Arabako Unibertsitate Ospitalea (Vitoria, País Basc))
López Jiménez, Luciano (Hospital Universitario Reina Sofía (Còrdova, Espanya))
López Reyes, Raquel (Hospital Universitari i Politècnic La Fe (València))
Jara-Palomares, Luis (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Pedrajas, José María (Hospital Clínico San Carlos (Madrid))
Mahé, Isabelle (Hôpital Louis Mourier)
Monreal, Manuel (Universidad Católica San Antonio de Murcia)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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. In patients with lung cancer and venous thromboembolism (VTE), the influence of cancer histology on outcome has not been consistently evaluated. 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. 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. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adenocarcinoma lung cancer ; Cancer associated thrombosis ; Histology ; Lung cancer ; Venous thrombolism
Publicat a:	Cancers, Vol. 14 (august 2022) , ISSN 2072-6694

DOI: 10.3390/cancers14174127
PMID: 36077663

11 p, 1.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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