BACKGROUND: While symptomatic venous thromboembolism adversely impacts survival among cancer patients, the outcome of cancer patients with unsuspected pulmonary embolism (UPE) found on routine cancer staging multi-row detector computed tomography (MDCT) scans is unknown. OBJECTIVE: To determine whether UPE detected on routine staging MDCT scans impacts overall survival among cancer patients. PATIENTS AND METHODS: We performed a matched cohort study of cancer patients diagnosed with UPE on routine staging scans between May 2003 and August 2006. Two controls (n = 137) were individually matched by age (± 5 years), cancer type and stage for each UPE patient (n = 70). We used Cox's proportional hazard models to compare the mortality between UPE patients and their matched controls. RESULTS: The hazard ratio (HR) for death among UPE patients was 1.51 (95% CI 1.01-2.27, P = 0.048). Compared with their matched controls, patients with UPE more proximal than the subsegmental arterial branches had a HR for death at 6 months of 2.28 (95% CI 1.20-4.33, P = 0.011) and an overall HR of 1.70 (95% CI 1.06-2.74, P = 0.027). Survival among UPE patients with isolated subsegmental PE (ISSPE) was not significantly different than that of matched controls (HR 1.04 95% CI 0.44-2.39, P = 0.92). CONCLUSIONS: UPE identified more proximal than the subsegmental arterial branches has a significant negative impact on survival among cancer patients.
BACKGROUND: While symptomatic venous thromboembolism adversely impacts survival among cancerpatients, the outcome of cancerpatients with unsuspected pulmonary embolism (UPE) found on routine cancer staging multi-row detector computed tomography (MDCT) scans is unknown. OBJECTIVE: To determine whether UPE detected on routine staging MDCT scans impacts overall survival among cancerpatients. PATIENTS AND METHODS: We performed a matched cohort study of cancerpatients diagnosed with UPE on routine staging scans between May 2003 and August 2006. Two controls (n = 137) were individually matched by age (± 5 years), cancer type and stage for each UPE patient (n = 70). We used Cox's proportional hazard models to compare the mortality between UPE patients and their matched controls. RESULTS: The hazard ratio (HR) for death among UPE patients was 1.51 (95% CI 1.01-2.27, P = 0.048). Compared with their matched controls, patients with UPE more proximal than the subsegmental arterial branches had a HR for death at 6 months of 2.28 (95% CI 1.20-4.33, P = 0.011) and an overall HR of 1.70 (95% CI 1.06-2.74, P = 0.027). Survival among UPE patients with isolated subsegmental PE (ISSPE) was not significantly different than that of matched controls (HR 1.04 95% CI 0.44-2.39, P = 0.92). CONCLUSIONS: UPE identified more proximal than the subsegmental arterial branches has a significant negative impact on survival among cancerpatients.
Authors: Clive Kearon; Elie A Akl; Anthony J Comerota; Paolo Prandoni; Henri Bounameaux; Samuel Z Goldhaber; Michael E Nelson; Philip S Wells; Michael K Gould; Francesco Dentali; Mark Crowther; Susan R Kahn Journal: Chest Date: 2012-02 Impact factor: 9.410
Authors: Renato D Lopes; Richard C Becker; L Kristin Newby; Eric D Peterson; Elaine M Hylek; Christopher B Granger; Mark Crowther; Tracy Wang; Antonio C Carvalho; Otavio Berwanger; Roberto R Giraldez; Gilson Soares Feitosa; Jorge Pinto Ribeiro; Eduardo Darze; Renato A K Kalil; Marianna Andrande; Fabio Villas Boas; Jadelson Andrade; Ana Thereza Rocha; Robert A Harrington; Antonio C Lopes; David A Garcia Journal: J Thromb Thrombolysis Date: 2012-07 Impact factor: 2.300
Authors: Jeffrey A Kline; Pierre-Marie Roy; Martin P Than; Jackeline Hernandez; D Mark Courtney; Alan E Jones; Andrea Penaloza; Charles V Pollack Journal: Thromb Res Date: 2012-04-03 Impact factor: 3.944
Authors: Aditya Bagrodia; Ranjit Sukhu; Andrew G Winer; Eric Levy; Michael Vacchio; Byron Lee; Eugene J Pietzak; Timothy F Donahue; Eugene Cha; Gopa Iyer; Daniel D Sjoberg; Andrew J Vickers; Jonathan E Rosenberg; Dean F Bajorin; Guido Dalbagni; Bernard H Bochner Journal: Clin Genitourin Cancer Date: 2017-08-10 Impact factor: 2.872