Blom JW, Osanto S, Rosendaal FRThe risk of a venous thrombotic event in lung cancer patients: higher risk for adenocarcinoma than squamous cell carcinoma. J Thromb Haemost 2: 1760-1765

Leiden University, Leyden, South Holland, Netherlands
Journal of Thrombosis and Haemostasis (Impact Factor: 5.72). 11/2004; 2(10):1760-5. DOI: 10.1111/j.1538-7836.2004.00928.x
Source: PubMed


Only limited data on the incidence of venous thrombosis in different types of malignancy are available. Patients with adenocarcinoma are believed to have the highest risk of developing venous thrombosis.
To study the incidence of thrombosis in patients with lung cancer, with an emphasis on the comparison between adenocarcinoma and squamous cell carcinoma, we have performed a cohort study of patients with non-small-cell lung cancer. In addition the risk associated with treatment and extent of disease was assessed.
A total of 537 patients with a first diagnosis of lung carcinoma were included. Patient and tumor characteristics as well as venous thrombotic events were recorded from the medical records and from the Anticoagulation Clinic.
Thrombotic risk in lung cancer patients was 20-fold higher than in the general population (standardized morbidity ratio (SMR): 20.0 (14.6-27.4). In the group of patients with squamous cell cancer we found 10 (10/258) cases (incidence: 21.2 per 1000 years) of venous thrombosis whereas in the group of patients with adenocarcinoma 14 (14/133) cases (incidence: 66.7 per 1000 years) occurred. The crude adjusted hazard ratio was 3.1 (95% CI: 1.4-6.9). The risk increased during chemotherapy and radiotherapy and in the presence of metastases.
The risk of venous thrombosis in lung cancer patients is increased 20-fold compared to the general population. Patients with adenocarcinoma have a higher risk than patients squamous cell carcinoma. During chemotherapy or radiotherapy and in the presence of metastases the risk is even higher.

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    • "In a previous study we demonstrated that DXR treatment induces a hypercoagulable state that may manifest in the acute vascular dynamics. It is in agreement with other studies demonstrating that patients treated with chemotherapy have a 4.8-fold increased risk for venous thromboembolism (VTE) [29-31]. Furthermore, LMWH, which is widely used in cancer patients for secondary and primary prophylaxis, was shown to be superior in reducing the risk of VTE [32-34]. "
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    • "Cancer is a disease that associates with venous thrombosis. Cancer patients with thrombosis have a worse prognosis due to the fact that cancer cells directly contribute to the hypercoagulable state [1], [2]. Recently, considerable effort has been made to identify novel therapeutic agents with both anti-cancer and antothrombosis activity. "
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    • "But it was reported as adenocarcinoma is more often than other types for cause of thromboembolic events. Blom et al. studied 537 patients and they received similar results [3] [4]. In present case adenocarcinoma was detected according to pathology report. "
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    ABSTRACT: The malignancies are commonly associated with enhanced thrombotic vascular events. The thrombotic events are also increased in lung cancer subtypes. Even, the systemic mortal thrombotic disorders were reported in the literature. We report a case of a nonsmall-cell carcinoma patient who progressed with widespread thrombosis.
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