J Cancer 2018; 9(17):3046-3057. doi:10.7150/jca.26008


Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review

Yupeng Li1,4, Yu Shang2,4, Wenwen Wang1, Shangwei Ning3,✉, Hong Chen1,✉

1. Department of Respiration, Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
2. Department of Respiration, First Hospital of Harbin, Harbin 150081, China.
3. College of Bioinformatics Science and Technology, Harbin Medical University, Harbin 150081, China.
4. Drs Yupeng Li and Yu Shang contribute equally to this article.

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Li Y, Shang Y, Wang W, Ning S, Chen H. Lung Cancer and Pulmonary Embolism: What Is the Relationship? A Review. J Cancer 2018; 9(17):3046-3057. doi:10.7150/jca.26008. Available from http://www.jcancer.org/v09p3046.htm

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Pulmonary embolism (PE) is gradually considered to be the third most common disease in the vascular disease category. Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males worldwide. Although initially appearing as distinct entities, lung cancer is a great risk factor for the development of PE. Pulmonary embolism is common in lung cancer patients, with a pooled incidence of 3.7%, and unsuspected pulmonary embolism (UPE) is also non-negligible with a rough rate ranging from 29.4% to 63%. Many risk factors of PE have been detected and could be classified into three categories: lung cancer-related, patient-related, and treatment-related factors. Decreased mean survival time could be significantly observed in lung cancer patients with PE or UPE compared to those only, but suspected PE has higher mortality than UPE. Prophylactic anticoagulant therapy benefit might be highest in patients with stage IV non-small cell lung cancer (NSCLC) or limited small cell lung cancer (SCLC), and heparin seems superior to warfarin for thrombotic prophylaxis. Periodically reassessing the risk-benefit ratio of anticoagulant treatment will be an efficient treatment strategy in lung cancer patients with PE.

Keywords: Pulmonary embolism, Lung cancer, Venous thromboembolism, Non-small cell lung cancer, Small cell lung cancer