Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review

Overview

Journal J Cancer

Specialty Oncology

Date 2018 Sep 14

PMID 30210627

Citations 19

Authors

YuPeng Li

Yu Shang

Wenwen Wang

Shangwei Ning

Hong Chen

Affiliations

Soon will be listed here.

Abstract

Pulmonary embolism (PE) is gradually considered to be the third most common disease in the vascular disease category. Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males worldwide. Although initially appearing as distinct entities, lung cancer is a great risk factor for the development of PE. Pulmonary embolism is common in lung cancer patients, with a pooled incidence of 3.7%, and unsuspected pulmonary embolism (UPE) is also non-negligible with a rough rate ranging from 29.4% to 63%. Many risk factors of PE have been detected and could be classified into three categories: lung cancer-related, patient-related, and treatment-related factors. Decreased mean survival time could be significantly observed in lung cancer patients with PE or UPE compared to those only, but suspected PE has higher mortality than UPE. Prophylactic anticoagulant therapy benefit might be highest in patients with stage IV non-small cell lung cancer (NSCLC) or limited small cell lung cancer (SCLC), and heparin seems superior to warfarin for thrombotic prophylaxis. Periodically reassessing the risk-benefit ratio of anticoagulant treatment will be an efficient treatment strategy in lung cancer patients with PE.

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References

Kadlec B, Skrickova J, Merta Z, Dusek L, Jarkovsky J . The incidence and predictors of thromboembolic events in patients with lung cancer. ScientificWorldJournal. 2014; 2014:125706. PMC: 3918375. DOI: 10.1155/2014/125706. View

Muraoka M, Mochinaga K, Sengyoku H, Ryu C, Ikuta Y, Tabuchi S . [Efficacy and safety of administration of low-dose unfractionated heparin (LDUH) for the prevention of pulmonary thromboembolism after surgery for lung cancer; the long term outcome]. Kyobu Geka. 2013; 66(2):93-100. View

Yang X, Zhang H, Kong F, Wang G, Gu Q, Zhao Z . Effect of Huisheng oral solution on coagulation function in perioperative period in patients with primary lung cancer. J Thorac Dis. 2017; 9(7):1891-1902. PMC: 5542976. DOI: 10.21037/jtd.2017.06.64. View

Attaran S, Somov P, Awad W . Randomised high- and low-dose heparin prophylaxis in patients undergoing thoracotomy for benign and malignant disease: effect on thrombo-elastography. Eur J Cardiothorac Surg. 2010; 37(6):1384-90. DOI: 10.1016/j.ejcts.2009.12.027. View

Keller T, Salge U, Konig H, Dodt J, Heiden M, Seitz R . Tissue factor is the only activator of coagulation in cultured human lung cancer cells. Lung Cancer. 2001; 31(2-3):171-9. DOI: 10.1016/s0169-5002(00)00196-3. View

Dentali F, Malato A, Ageno W, Imperatori A, Cajozzo M, Rotolo N . Incidence of venous thromboembolism in patients undergoing thoracotomy for lung cancer. J Thorac Cardiovasc Surg. 2008; 135(3):705-6. DOI: 10.1016/j.jtcvs.2007.10.036. View

Kostecka I, Haponowicz B, Sienkiewicz P, Wierzbicka M . [Concentration of prothrombin fragments 1+2 (F1+2) and thrombin-antithrombin III complexes (TAT)in patients with primary non-small cell lung cancer, before and after resection]. Przegl Lek. 2001; 57(9):451-4. View

Nichols L, Saunders R, Knollmann F . Causes of death of patients with lung cancer. Arch Pathol Lab Med. 2012; 136(12):1552-7. DOI: 10.5858/arpa.2011-0521-OA. View

Sun J, Kim T, Lee J, Park Y, Ahn J, Kim H . Unsuspected pulmonary emboli in lung cancer patients: the impact on survival and the significance of anticoagulation therapy. Lung Cancer. 2009; 69(3):330-6. DOI: 10.1016/j.lungcan.2009.11.015. View

10.

Tavecchio L, Ravasi G, Bedini A, Gramaglia A, Milani F . Surgery after radiochemotherapy for stage III lung cancer: postoperative complications and late results. J Surg Oncol. 1994; 56(1):2-6. DOI: 10.1002/jso.2930560103. View

11.

Hu W, Zhang Z . A phase II clinical study of using nab-paclitaxel as second-line chemotherapy for Chinese patients with advanced non-small cell lung cancer. Med Oncol. 2015; 32(6):498. DOI: 10.1007/s12032-015-0498-x. View

12.

Levitan N, Dowlati A, Craffey M, Tahsildar H, Mackay W, McKenney J . A brief intensive cisplatin-based outpatient chemotherapy regimen with filgrastim and megestrol acetate support for advanced non-small cell lung cancer: results of a phase II trial. Lung Cancer. 1999; 22(3):227-34. DOI: 10.1016/s0169-5002(98)00087-7. View

13.

Lebeau B, Chastang C, Brechot J, Capron F, Dautzenberg B, Delaisements C . Subcutaneous heparin treatment increases survival in small cell lung cancer. "Petites Cellules" Group. Cancer. 1994; 74(1):38-45. DOI: 10.1002/1097-0142(19940701)74:1<38::aid-cncr2820740108>3.0.co;2-e. View

14.

Powell S, Beitinjaneh A, Tessema M, Bliss R, Kratzke R, Leach J . Phase II study of topotecan and bevacizumab in advanced, refractory non--small-cell lung cancer. Clin Lung Cancer. 2013; 14(5):495-501. PMC: 4524809. DOI: 10.1016/j.cllc.2013.04.009. View

15.

Levy A, Bardet E, Lacas B, Pignon J, Adam J, Lacroix L . A phase II open-label multicenter study of gefitinib in combination with irradiation followed by chemotherapy in patients with inoperable stage III non-small cell lung cancer. Oncotarget. 2016; 8(9):15924-15933. PMC: 5362534. DOI: 10.18632/oncotarget.12741. View

16.

Numico G, Garrone O, Dongiovanni V, Silvestris N, Colantonio I, Di Costanzo G . Prospective evaluation of major vascular events in patients with nonsmall cell lung carcinoma treated with cisplatin and gemcitabine. Cancer. 2005; 103(5):994-9. DOI: 10.1002/cncr.20893. View

17.

Wang Z, Fu J, Diao D, Dang C . Plasma D-dimer level in the perioperative period in non-small-cell lung cancer. Thorac Cancer. 2011; 2(4):207-212. DOI: 10.1111/j.1759-7714.2011.00055.x. View

18.

Verso M, Chiari R, Mosca S, Franco L, Fischer M, Paglialunga L . Incidence of Ct scan-detected pulmonary embolism in patients with oncogene-addicted, advanced lung adenocarcinoma. Thromb Res. 2015; 136(5):924-7. DOI: 10.1016/j.thromres.2015.09.006. View

19.

Altinbas M, Coskun H, Er O, Ozkan M, Eser B, Unal A . A randomized clinical trial of combination chemotherapy with and without low-molecular-weight heparin in small cell lung cancer. J Thromb Haemost. 2004; 2(8):1266-71. DOI: 10.1111/j.1538-7836.2004.00871.x. View

20.

Fuentes H, Oramas D, Paz L, Casanegra A, Mansfield A, Tafur A . Meta-analysis on anticoagulation and prevention of thrombosis and mortality among patients with lung cancer. Thromb Res. 2017; 154:28-34. DOI: 10.1016/j.thromres.2017.03.024. View