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. 2022 Aug 26;14(17):4127.
doi: 10.3390/cancers14174127.

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

Pedro Ruiz-Artacho  1   2   3 , Ramón Lecumberri  4   5 , Javier Trujillo-Santos  6 , Carme Font  7 , Juan J López-Núñez  8   9   10 , María Luisa Peris  11   12 , Carmen Díaz Pedroche  13 , José Luis Lobo  14 , Luciano López Jiménez  15 , Raquel López Reyes  16 , Luis Jara Palomares  17 , José María Pedrajas  18 , Isabelle Mahé  19 , Manuel Monreal  3   20 , The Riete Investigators
Affiliations

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

Pedro Ruiz-Artacho et al. Cancers (Basel). .

Abstract

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: adenocarcinoma lung cancer; cancer associated thrombosis; histology; lung cancer; venous thrombolism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
VTE recurrences and major bleeding while on anticoagulant treatment for patients with adenocarcinoma lung cancer.
Figure 2
Figure 2
VTE recurrences and major bleeding while on anticoagulant treatment for patients with other types of lung cancer.
See this image and copyright information in PMC

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