Could venous thromboembolism and major bleeding be indicators of lung cancer mortality? A nationwide database study

BMC Cancer

Catherine Quantin¹  Jonathan Cottenet¹  Eric Benzenine¹  Philippe Fagnoni²  Jennifer Howlett²  Pascal Foucher³ 

[1] Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comté University;CHRU Dijon, Pharmacy;Department of Thoracic Oncology CHU;

关键词: Lung cancer;    Venous thromboembolism;    Anticoagulant therapy;    Major bleeding;    Medico-administrative data;   

DOI  :  10.1186/s12885-020-06930-1

来源: DOAJ

【 摘 要 】

Abstract Background Venous thromboembolism (VTE) is highly prevalent in cancer patients and can cause severe morbidity. VTE treatment is essential, but anticoagulation increases the risk of major bleeding. The purpose was to evaluate the impact of VTE and major bleeding on survival and to identify significant risk factors for these events in lung cancer patients. Methods Data were extracted from a permanent sample of the French national health information system (including hospital and out-of-hospital care) from 2009 to 2016. All episodes of VTE and major bleeding events within one year after cancer diagnosis were identified. A Cox model was used to analyse the effect of VTE and major bleeding on the patients’ one-year survival. VTE and major bleeding risk factors were analysed with a Fine and Gray survival model. Results Among the 2553 included patients with lung cancer, 208 (8%) had a VTE episode in the year following diagnosis and 341 (13%) had major bleeding. Almost half of the patients died during follow-up. Fifty-six (60%) of the patients presenting with pulmonary embolism (PE) died, 48 (42%) of the patients presenting with deep vein thrombosis (DVT) alone died and 186 (55%) of those presenting with a major bleeding event died. The risk of death was significantly increased following PE and major bleeding events. VTE concomitant with cancer diagnosis was associated with an increased risk of VTE recurrence beyond 6 months after the first VTE event (sHR = 4.07 95% CI: 1.57–10.52). Most major bleeding events did not appear to be related to treatment. Conclusion VTE is frequent after a diagnosis of lung cancer, but so are major bleeding events. Both PE and major bleeding are associated with an increased risk of death and could be indicators of lung cancer mortality.

【 授权许可】

Unknown