TY - JOUR
T1 - Early venous thromboembolic events are associated with worse prognosis in patients with lung cancer
AU - Kourelis, Taxiarchis V.
AU - Wysokinska, Ewa M.
AU - Wang, Yi
AU - Yang, Ping
AU - Mansfield, Aaron S.
AU - Tafur, Alfonso J.
N1 - Publisher Copyright:
© 2014 Elsevier Ireland Ltd.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Objectives: Venous thromboembolic events (VTE) are a leading cause of death in cancer patients. We hypothesized that early VTE (EVTE, within 3 months of diagnosis) in patients with lung cancer (LC) are associated with worse overall survival (OS). Materials and methods: We identified 727 patients with LC between 1998 and 2011. Late VTE (LVTE) were defined as VTE occurring after 3 months from LC diagnosis. Advance disease (AD) was defined as patients with Stage IV non-small cell lung cancer (NSCLC) or extensive stage small cell lung cancer (SCLC), and non-advanced disease (non-AD) was defined as ≤Stage III NSCLC or limited stage SCLC. Results: Out of 727 patients included in our review, 617 patients had NSCLC (85%), 94 (13%) SCLC, and 16 (2%) low grade neuroendocrine tumors. Ninety five patients (13%) experienced VTE, 44 (6%) experienced an EVTE and 49 (7%) had a LVTE. Patients with an EVTE had worse OS when compared to all other patients (medians 4 vs. 17 months, p<. 0.0001). EVTE were associated with worse OS in patients with non-AD (medians 12 vs. 42 months, p=. 0.01) and AD (medians 4 vs. 6 months, p=. 0.02). When considering patients with NSCLC only, in a multivariate model that included age, stage, performance status >2, administration of chemotherapy and Charlson comorbidity index, EVTE were an independent predictor of increased mortality (HR 2.4; 95% CI 1.6-3.3). Conclusions: EVTE are associated with worse OS, irrespective of stage of the disease. Our findings underscore the need for an efficient preventive strategy for VTE among patients with lung cancer.
AB - Objectives: Venous thromboembolic events (VTE) are a leading cause of death in cancer patients. We hypothesized that early VTE (EVTE, within 3 months of diagnosis) in patients with lung cancer (LC) are associated with worse overall survival (OS). Materials and methods: We identified 727 patients with LC between 1998 and 2011. Late VTE (LVTE) were defined as VTE occurring after 3 months from LC diagnosis. Advance disease (AD) was defined as patients with Stage IV non-small cell lung cancer (NSCLC) or extensive stage small cell lung cancer (SCLC), and non-advanced disease (non-AD) was defined as ≤Stage III NSCLC or limited stage SCLC. Results: Out of 727 patients included in our review, 617 patients had NSCLC (85%), 94 (13%) SCLC, and 16 (2%) low grade neuroendocrine tumors. Ninety five patients (13%) experienced VTE, 44 (6%) experienced an EVTE and 49 (7%) had a LVTE. Patients with an EVTE had worse OS when compared to all other patients (medians 4 vs. 17 months, p<. 0.0001). EVTE were associated with worse OS in patients with non-AD (medians 12 vs. 42 months, p=. 0.01) and AD (medians 4 vs. 6 months, p=. 0.02). When considering patients with NSCLC only, in a multivariate model that included age, stage, performance status >2, administration of chemotherapy and Charlson comorbidity index, EVTE were an independent predictor of increased mortality (HR 2.4; 95% CI 1.6-3.3). Conclusions: EVTE are associated with worse OS, irrespective of stage of the disease. Our findings underscore the need for an efficient preventive strategy for VTE among patients with lung cancer.
KW - Incidence
KW - Lung neoplasms
KW - Prognosis
KW - Survival
KW - Thrombosis
KW - Venous thromboembolism
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U2 - 10.1016/j.lungcan.2014.10.003
DO - 10.1016/j.lungcan.2014.10.003
M3 - Article
C2 - 25453848
AN - SCOPUS:84961291398
SN - 0169-5002
VL - 86
SP - 358
EP - 362
JO - Lung Cancer
JF - Lung Cancer
IS - 3
ER -