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Clinical features of patients with lung cancer accompanied by thromboembolism or disseminated intravascular coagulation

Authors Kanaji N, Mizoguchi H, Inoue T, Tadokoro A, Watanabe N, Ishii T, Tojo Y, Yamaguchi M, Kadowaki N

Received 5 February 2018

Accepted for publication 12 April 2018

Published 1 August 2018 Volume 2018:14 Pages 1361—1368


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh

Nobuhiro Kanaji,1 Hitoshi Mizoguchi,1 Takuya Inoue,1 Akira Tadokoro,2 Naoki Watanabe,1 Tomoya Ishii,1 Yasunori Tojo,2 Masahiro Yamaguchi,3 Norimitsu Kadowaki1

1Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 2Department of Respiratory Medicine, National Hospital Organization Takamatsu Medical Center, 3Department of Internal Medicine, Shodoshima Central Hospital, Kagawa, Japan

Purpose: Thromboembolism (TE) and disseminated intravascular coagulation (DIC) are often present concomitantly. This study aimed to investigate the clinical features of patients with lung cancer and TE and/or DIC.
Patients and methods: Data on 716 patients with pathologically confirmed diagnoses of lung cancer were retrospectively analyzed for TE/DIC.
Results: TE was identified in 16 patients (2.2%) and DIC was identified in 5 (0.7%) during the diagnosis of cancer. TE was more often observed in adenocarcinoma (4.0%). Both TE and DIC were more often observed in stage IV (4.7% and 1.5%, respectively). In patients with stage IV adenocarcinoma who received some systemic treatment, overall survival (OS) was significantly shorter in patients with TE (median 280 days) and with DIC (72 days) than in non-TE/DIC patients (538 days). Multivariate analysis showed that older age, poor performance status, greater number of metastatic organs, no EGFR mutation/ALK fusion, presence of interstitial lung disease, and DIC were poor prognostic factors for OS. In 339 patients in stage IV, 25 (7.4%) and 21 (6.2%) patients had TE and DIC, respectively, during the course. Six patients exhibited both TE and DIC. TE was more often observed in adenocarcinoma (20 of 196 patients; 10.2%). Patients with DIC had extremely shorter survival (median 13 days) after onset. Cancer control by systemic therapy, such as chemotherapy and molecular-targeted therapy, contributed to long survival.
Conclusion: Patients with TE/DIC had shorter OS than patients without TE/DIC. Control of lung cancer by systemic therapy was important for longer survival after the onset of events.

Keywords: deep vein thrombosis, pulmonary embolism, survival, Trousseau’s syndrome, venous thrombotic event, prognosis

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