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.