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Nakamura J, Tsujino I, Shima H, Nakaya T, Sugimoto A, Sato T, Watanabe T, Ohira H, Suzuki M, Yokota I, Konno S. Impact of cancer on the prevalence, management, and outcome of patients with chronic thromboembolic pulmonary hypertension. J Thromb Thrombolysis 2023; 56:588-593. [PMID: 37615801 DOI: 10.1007/s11239-023-02868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Chronic thromboembolic pulmonary hypertension (CTEPH) results from unresolved thrombotic obstruction of the pulmonary vasculature. Cancer is a known risk factor for CTEPH. This study aimed to determine the impact of cancer on the prevalence, management, and outcomes of patients with CTEPH. MATERIALS AND METHODS In this retrospective study involving 99 patients sequentially diagnosed with CTEPH in our hospital, the prevalence of 10 comorbid conditions including a past history of cancer at the time of CTEPH diagnosis were calculated. RESULTS Among the 99 patients, 17 (17%) had a history of cancer. Breast cancer (n = 6) was the most common cancer type, followed by gastrointestinal cancer (n = 3), uterine cancer (n = 2), and malignant lymphoma (n = 2). Between patients with and without cancer, there were no differences in the demographics, severity of CTEPH, and management; however, the 5-year survival rate was lower for patients with cancer (65%) than for those without (89%). In addition, patients with cancer had significantly worse survival than those without (p = 0.03 by log-rank test). During follow-up, nine patients developed cancer after the diagnosis of CTEPH. Among the 99 patients, 13 died during follow-up, 6 (46%) of whom died of cancer. CONCLUSIONS 17% of our patients with CETPH were diagnosed with cancer, with breast and gastrointestinal tract cancers being the most common. Cancer comorbidity was associated with a poor prognosis and contributed to death in 46% of deceased patients. The impact of cancer on CTEPH should be further evaluated in the future.
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Affiliation(s)
- Junichi Nakamura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Ichizo Tsujino
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan.
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Hokkaido, Japan.
| | - Hideki Shima
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Toshitaka Nakaya
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Ayako Sugimoto
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Takahiro Sato
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Hokkaido, Japan
| | - Taku Watanabe
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Hiroshi Ohira
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan
- Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Hokkaido, Japan
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Durin L, Noël-Savina E, Héluain V, Mattei P, Mazières J, Prévot G. Impact of pulmonary hypertension on lung cancer management. Respir Med Res 2022; 82:100964. [DOI: 10.1016/j.resmer.2022.100964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
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Sørensen HT, Skajaa N, Klok FA, Laugesen K, Farkas DK. Cancer Risk in Pulmonary Hypertension Patients. Clin Epidemiol 2022; 14:173-177. [PMID: 35210864 PMCID: PMC8859871 DOI: 10.2147/clep.s345054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Patients and Methods Results Conclusion
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Affiliation(s)
- Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus N, DK-8200, Denmark
- Correspondence: Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University, Olof Palmes Allé 43-45, Aarhus N, DK-8200, Denmark, Email
| | - Nils Skajaa
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus N, DK-8200, Denmark
| | - Frederikus Albertus Klok
- Department of Medicine - Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Kristina Laugesen
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus N, DK-8200, Denmark
| | - Dóra Körmendiné Farkas
- Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus N, DK-8200, Denmark
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Yang X, Wang L, Lin L, Liu X. Elevated Pulmonary Artery Systolic Pressure is Associated with Poor Survival of Patients with Non-Small Cell Lung Cancer. Cancer Manag Res 2020; 12:6363-6371. [PMID: 32821155 PMCID: PMC7419633 DOI: 10.2147/cmar.s260857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose Pulmonary hypertension (PH) is an important comorbidity of lung cancer, PH in lung cancer patients is gradually gaining interest because of its apparent high prevalence, but the impact of PH on the outcomes of lung cancer remains uncertain and had rarely been discussed. We aimed to evaluate the prevalence, determinants and prognosis value of elevated pulmonary artery systolic pressure (PASP) in non-small cell lung cancer patients. Patients and Methods In this retrospective study, subjects with a new and pathological confirmed diagnosis of lung cancer were enrolled. All patients underwent transthoracic echocardiography before received treatment. Pulmonary artery systolic pressure was measured by transthoracic echocardiography. Lung cancer subtypes were categorized by WHO classification of lung tumors. Hazard ratios (HR) were estimated by using Cox regression models. Results Among 612 non-small cell lung cancer (NSCLC) patients, 19.8% coexisted with PH. After adjustment for age, symptom, coagulation disorders, lymph node metastasis, distant metastasis, histological type, clinical stage, PASP ≥35mmHg was significantly associated with the decreased overall survival (OS) of NSCLC (P= 0.028). Moreover, PASP ≥45mmHg was an independent predictor for perioperative death. Independent factors of comorbid elevated PASP were age, the presence of intrapulmonary metastasis and coagulation disorders. Conclusion These findings suggest that PASP is an independent prognostic risk factor for NSCLC patients. Main determinants of elevated PASP are age, the presence of intrapulmonary metastasis and coagulation disorders.
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Affiliation(s)
- Xue Yang
- Department of Geriatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Lina Wang
- Department of Geriatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Lianjun Lin
- Department of Geriatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Xinmin Liu
- Department of Geriatrics, Peking University First Hospital, Beijing 100034, People's Republic of China
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