Clinical characteristics and outcomes of lung cancer with pulmonary embolism.

BACKGROUND

Cancer patients have a higher risk for thrombosis that is usually related to advanced stage and poor prognosis. This study aimed to identify the clinical picture and outcome of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) patients with pulmonary embolism (PE).

PATIENTS AND METHODS

From 1996 to 2005, the clinical presentation of lung cancer patients with PE was evaluated. Their survival was compared with matched controls by log-rank test.

RESULTS

A total of 24 patients, 17 men (70.8%) and 7 women (median age: 62.5 years), were identified. Nineteen patients (79.2%) initially presented with advanced lung cancer (16 stage IV, 1 stage III-b NSCLC and 2 extensive-stage SCLC). Wells' clinical prediction score for PE only predicted moderate probability (median: 5.25). In patients with PE, survival was significantly shorter than in matched control patients (243.5 vs. 327 days, p = 0.01). This difference was more significant when PE presented concomitant with cancer (p = 0.003) than when PE developed during cancer treatment (p = 0.206).

CONCLUSIONS

PE is an important event in lung cancer patients which usually occurs in advanced disease and affects survival. In patients presenting PE at the initial diagnosis of cancer, the prognosis was the worst.