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Pulmonary embolism concurrent with lung cancer and central emboli predict mortality in patients with lung cancer and pulmonary embolism.

Background
Patients with lung cancer commonly experience pulmonary embolism (PE). The aim of the present study was to examine the clinical features of patients with lung cancer and PE and to investigate prognostic factors in these patients.


Methods
This retrospective study divided patients with lung cancer and PE into a group of patients with PE diagnosed concomitantly with lung cancer (concurrent group) and a group with PE detected after lung cancer (sequential group), compared the clinical characteristics of patients in the two groups, and investigated prognostic factors in these patients.


Results
The study population consisted of the concurrent group [27 patients (10.1%)] and the sequential group [240 patients (89.9%)]. The concurrent group exhibited higher percentages of stage I cancer at the diagnosis of PE [6 (22.2%) vs. 8 (3.3%), P<0.001] and right ventricular (RV) dilation on computed tomography (CT) [14 (51.9%) vs. 41 (17.1%), P<0.001], as well as lower rate of small cell carcinoma [1 (3.7%) vs. 49 (20.4%), P=0.036] than the sequential group. PE concurrent with lung cancer [hazard ratio (HR) =2.64, 95% confidence interval (CI): 1.57-4.43, P<0.001] and central PE (HR =1.46, 95% CI: 1.02-2.10, P=0.04) were independent predictors of mortality in patients with lung cancer and PE.


Conclusions
PE concurrent with lung cancer is characterized by more severe PE and infrequent small cell carcinoma. PE concurrent with lung cancer and central emboli may be independent prognostic factors in patients with lung cancer and PE.