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Thromboembolism (TE) is common in patients with non-small cell lung cancer (NSCLC) and is associated with poor prognosis.
recent advances in NSCLC have been able to identify molecular subtypes, such as ALC and EGFR mutations.
the association between these subsypes and TE risk has not been fully studied.
recently, a study published in Journal of Thrombosis and Haemostasis, an authoritative journal of thrombosis and clotting diseases, looked retrospective cohort studies of NSCLC patients who were treated at the Cleveland Clinic from July 2002 to July 2017 and obtained molecular classification and follow-up information for patients.
TE events include deep vein thrombosis (DVT), pulmonary embolism (PE), visceral venous thrombosis (VVT), and arterial events.
researchers used the Kaplan-Meier method to estimate TE-free and total survival rates in patients with each molecular subtype (wild, ALK and EGFR mutants).
Cox Proportional Risk Regression Analysis is used to identify factors related to endpoint TE and overall survival.
TE is analyzed as a conditional, time-dependent covariative variable to assess its impact on overall survival.
study population included 461 patients, about half of them women (n-263,57%), and 58% of patients over 65 (n-270).
461 patients had TE (21.3%) out of 461 patients during a 33.1-month mid-level follow-up period.
the highest cumulative rate of TE was observed in patients with ALC mutant NSCLC (N=20/46,43.5%), followed by EGFR mutant cancer patients (N=35/165,21.2%) and wild cancer patients (N=43/250,17.2%), p<0.05%.
six months of follow-up, the cumulative TE rate of ALK mutant cancer patients was 15.7% (95% CI: 5.0-26.4%) and 8.8% of EGFR mutant cancer patients. 8% (95% CI: 4.4-13.2%), while 9.2% (95% CI: 5.4-12.9%) of wild cancer patients.
the total survival of patients who had experienced TE was poor (all patients: HR:2.8, 95% CI was 2.1-3.6, p.lt;0.001).
result, the incidence of TE was highest in patients with advanced lung adenocarcinoma with ALK mutations.
TE is associated with poor survival outcomes in patients with various molecular subsypes of cancer, and these results should be taken into account when making thrombosis prevention decisions.
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