Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer
Abstract Background Lung cancer patients face a high risk of thromboembolism (TE), which is considered to be a poor prognostic factor. However, the impact of symptomatic cerebral infarction (CI) and pulmonary embolism (PE) on the prognosis of advanced non‐small cell lung cancer (NSCLC) patients is n...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5647 |
| _version_ | 1827951732547649536 |
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| author | Ryota Nakamura Tadaaki Yamada Satomi Tanaka Aosa Sasada Shinsuke Shiotsu Nozomi Tani Takayuki Takeda Yusuke Chihara Soichi Hirai Yoshizumi Takemura Akihiro Yoshimura Kenji Morimoto Masahiro Iwasaku Shinsaku Tokuda Young Hak Kim Koichi Takayama |
| author_facet | Ryota Nakamura Tadaaki Yamada Satomi Tanaka Aosa Sasada Shinsuke Shiotsu Nozomi Tani Takayuki Takeda Yusuke Chihara Soichi Hirai Yoshizumi Takemura Akihiro Yoshimura Kenji Morimoto Masahiro Iwasaku Shinsaku Tokuda Young Hak Kim Koichi Takayama |
| author_sort | Ryota Nakamura |
| collection | DOAJ |
| description | Abstract Background Lung cancer patients face a high risk of thromboembolism (TE), which is considered to be a poor prognostic factor. However, the impact of symptomatic cerebral infarction (CI) and pulmonary embolism (PE) on the prognosis of advanced non‐small cell lung cancer (NSCLC) patients is not fully understood. Methods We retrospectively identified 46 patients with advanced NSCLC who developed symptomatic CI or PE at five hospitals in Japan between January 2010 and December 2019. Prognosis and biomarker levels after incident CI and PE were investigated. Results Of the 46 patients, 36 developed symptomatic CI, and 10 developed symptomatic PE. The median follow‐up duration after incident CI and PE was 18.2 months. Although the proportion of Common Terminology Criteria for Adverse Events grade 4 tended to be higher in patients with PE than in those with CI (30% vs. 11%, p = 0.16), the overall survival (OS) after incident TE tended to be worse in patients with CI than in those with PE (median 2.3 months vs. 9.1 months, log‐rank test p = 0.17). Multivariate analysis showed that OS after CI was worse in patients with high D‐dimer (DD) levels than in those with low DD levels at the time of incident CI (median 1.3 months vs. 8.3 months, log‐rank p < 0.001). Conclusions This retrospective study demonstrated that the prognosis of patients tended to be poorer after CI than after PE. The DD levels at the time of incident CI might be a promising predictor of clinical outcomes in advanced NSCLC patients who develop CI. |
| first_indexed | 2024-04-09T13:45:56Z |
| format | Article |
| id | doaj.art-69b2b1be97d84bcea46fd2c77252efe8 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T13:45:56Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-69b2b1be97d84bcea46fd2c77252efe82023-05-09T04:04:18ZengWileyCancer Medicine2045-76342023-04-011289097910510.1002/cam4.5647Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancerRyota Nakamura0Tadaaki Yamada1Satomi Tanaka2Aosa Sasada3Shinsuke Shiotsu4Nozomi Tani5Takayuki Takeda6Yusuke Chihara7Soichi Hirai8Yoshizumi Takemura9Akihiro Yoshimura10Kenji Morimoto11Masahiro Iwasaku12Shinsaku Tokuda13Young Hak Kim14Koichi Takayama15Department of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Respiratory Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto JapanDepartment of Respiratory Medicine Japanese Red Cross Kyoto Daiichi Hospital Kyoto JapanDepartment of Pulmonary Medicine Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto JapanDepartment of Respiratory Medicine Japanese Red Cross Kyoto Daini Hospital Kyoto JapanDepartment of Respiratory Medicine Uji‐Tokushukai Medical Center Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine Otsu City Hospital Shiga JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanDepartment of Pulmonary Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto JapanAbstract Background Lung cancer patients face a high risk of thromboembolism (TE), which is considered to be a poor prognostic factor. However, the impact of symptomatic cerebral infarction (CI) and pulmonary embolism (PE) on the prognosis of advanced non‐small cell lung cancer (NSCLC) patients is not fully understood. Methods We retrospectively identified 46 patients with advanced NSCLC who developed symptomatic CI or PE at five hospitals in Japan between January 2010 and December 2019. Prognosis and biomarker levels after incident CI and PE were investigated. Results Of the 46 patients, 36 developed symptomatic CI, and 10 developed symptomatic PE. The median follow‐up duration after incident CI and PE was 18.2 months. Although the proportion of Common Terminology Criteria for Adverse Events grade 4 tended to be higher in patients with PE than in those with CI (30% vs. 11%, p = 0.16), the overall survival (OS) after incident TE tended to be worse in patients with CI than in those with PE (median 2.3 months vs. 9.1 months, log‐rank test p = 0.17). Multivariate analysis showed that OS after CI was worse in patients with high D‐dimer (DD) levels than in those with low DD levels at the time of incident CI (median 1.3 months vs. 8.3 months, log‐rank p < 0.001). Conclusions This retrospective study demonstrated that the prognosis of patients tended to be poorer after CI than after PE. The DD levels at the time of incident CI might be a promising predictor of clinical outcomes in advanced NSCLC patients who develop CI.https://doi.org/10.1002/cam4.5647cerebral infarctionischemic strokenon‐small cell lung cancerpulmonary embolismthromboembolism |
| spellingShingle | Ryota Nakamura Tadaaki Yamada Satomi Tanaka Aosa Sasada Shinsuke Shiotsu Nozomi Tani Takayuki Takeda Yusuke Chihara Soichi Hirai Yoshizumi Takemura Akihiro Yoshimura Kenji Morimoto Masahiro Iwasaku Shinsaku Tokuda Young Hak Kim Koichi Takayama Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer Cancer Medicine cerebral infarction ischemic stroke non‐small cell lung cancer pulmonary embolism thromboembolism |
| title | Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer |
| title_full | Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer |
| title_fullStr | Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer |
| title_full_unstemmed | Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer |
| title_short | Comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non‐small cell lung cancer |
| title_sort | comparison of the prognosis of symptomatic cerebral infarction and pulmonary embolism in patients with advanced non small cell lung cancer |
| topic | cerebral infarction ischemic stroke non‐small cell lung cancer pulmonary embolism thromboembolism |
| url | https://doi.org/10.1002/cam4.5647 |
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