Clinical features of patients with lung cancer accompanied by thromboembolism or disseminated intravascular coagulation

Figures & data

Table 1 Patient’s characteristics at the diagnosis with lung cancer

Characteristics	Non-TE/DIC (n=697)	TE (n=16)	P-value (vs non-TE/DIC)	DIC (n=5)	P-value (vs non-TE/DIC)
Age (years)
Average (range)	70 (23–92)	60 (41–81)	0.0063	74 (68–81)	0.1912
Gender
Male	508	9	0.1588	2	0.1291
Female	189	7		3
Smoking status
Never	161	6	0.2288	2	0.3317
Ever	533	10		3
Pack-year, average	57	35	0.0308	63	0.8719
Unknown	3	0		0
PS
0–1	577	10	0.0468	2	0.0401
2–4	120	6		3
ILD
Yes	151	3	1.0000	2	0.2996
No	546	13		3
Histology
Small	93	1 (1.0%)	0.7087	2 (2.1%)	0.1378
Adenocarcinoma	360	15 (4.0%)	0.0006	3 (0.8%)	1.0000
Squamous	160	0	0.0296	0	0.5938
Others	21	0	1.0000	0	1.0000
NSCLC, NOS	63	0	0.3848	0	1.0000
Stage
I	147	0	0.0534	0	0.5895
II	68	0	0.3871	0	1.0000
III	162	0	0.0298	0	0.5947
IV	320	16 (4.7%)	<0.0001	5 (1.5%)	0.0209
Number of metastatic organs in stage IV
Average (range)	1.89 (1–9)	2.94 (1–9)	0.0422	3.20 (1–5)	0.1764

Abbreviations: DIC, disseminated intravascular coagulation; ILD, interstitial lung disease; NOS, not otherwise specified; NSCLC, non-small-cell lung cancer; PS, performance status; TE, thromboembolism.

Figure 1 Kaplan–Meier curves of overall survival in patients with stage IV adenocarcinoma who received some systemic treatment, dependent on the status of (A) thromboembolism and (B) DIC observed at cancer diagnosis.

Abbreviation: DIC, disseminated intravascular coagulation.

Table 2 Risk factors associated with overall survival in patients with stage IV adenocarcinoma

Characteristics	n	Median (days)	Univariate analysis	Multivariate analysis
			P-value	HR (95% CI)	P-value
Age (years)
Older (≥75 years)	46	314	0.0379	1.82 (1.18–2.78)	0.0063
Younger (<75 years)	131	584
Gender
Male	101	393	0.0106	1.59 (0.95–2.66)	0.0759
Female	76	638
Smoking status
Ever	112	486	0.4422	0.72 (0.43–1.23)	0.2322
Never	65	538
PS
2–4	35	176	<0.0001	2.98 (1.89–4.70)	<0.0001
0–1	142	599
Number of metastatic organs
≥3	52	360	0.0039	1.68 (1.10–2.55)	0.0161
1–2	125	596
EGFR mutation or ALK fusion
No	108	396	0.0001	1.85 (1.22–2.81)	0.0036
Yes	69	679
ILD
Yes	25	267	0.0116	1.90 (1.11–3.26)	0.0197
No	152	539
TE
Yes	15	280	0.0454	1.06 (0.55–2.08)	0.8557
No	162	538
DIC
Yes	3	72	<0.0001	26.75 (6.58–108.71)	<0.0001
No	174	528

Abbreviations: ALK, anaplastic lymphoma kinase; DIC, disseminated intravascular coagulation; EGFR, epidermal growth factor receptor; ILD, interstitial lung disease; PS, performance status; TE, thromboembolism.

Table 3 Thromboembolism and/or DIC occurred during total treatment period of patients with stage IV lung cancer

Histology	n	TE		DIC
		n (DVT/PE/arterial)a	P-value	n	P-value
Small	58	2 (3.4%) (1/0/1)	0.3991	4 (6.9%)	0.7688
Adenocarcinoma	196	20 (10.2%) (15/8/5)	0.0343	11 (5.6%)	0.6544
Squamous	49	2 (4.1%) (0/0/2)	0.5526	5 (10.2%)	0.2215
Others	7	0	1.0000	0	1.0000
NSCLC, NOS	29	1 (3.4%) (1/0/0)	0.7083	1 (3.4%)	1.0000
Total	339	25 (7.4%) (17/8/8)		21 (6.2%)

Note:

a Each sum may not in accordance with the total number.

Abbreviations: DIC, disseminated intravascular coagulation; DVT, deep vein thrombosis; NOS, not otherwise specified; NSCLC, non-small-cell lung cancer; PE, pulmonary embolism; TE, thromboembolism.

Figure 2 Kaplan–Meier curves of survival after the onset of TE and/or DIC occurred during the total course, dependent on the status of (A) event type and (B) systemic therapy (chemotherapy or molecular-targeted therapy).

Abbreviations: DIC, disseminated intravascular coagulation; PD, progressive disease; PR, partial response; SD, stable disease; TE, thromboembolism.

Table 4 Risk factors associated with survival after the onset of thromboembolism and/or DIC

Characteristics	n	Median (days)	Univariate analysis	Multivariate analysis
			P-value	HR (95% CI)	P-value
Age (years)
Older (≥75 years)	6	16	0.5159	0.97 (0.31–3.03)	0.9627
Younger (<75 years)	34	38
EGFR mutation or ALK fusion
No	32	28	0.0469	3.21 (1.16–8.92)	0.0249
Yes	8	199
ILD
Yes	10	38	0.3639	0.73 (0.23–2.33)	0.5903
No	30	38
Histology
Small	6	28
Adenocarcinoma	27	118	0.0202	0.42 (0.13–1.33)	0.1395
Squamous	12	12
TE/DIC
TE	25	223
DIC	21	13	<0.0001	8.45 (2.87–24.89)	0.0001
Chemotherapy or molecular-targeted therapy, response
No	14	8	<0.0001	9.69 (2.68–35.11)	0.0005
Yes, PD	12	28
Yes, SD or PR	14	365
Anticoagulation therapy
No	8	8	0.0027	2.45 (0.85–7.06)	0.0977
Yes	32	83

Abbreviations: ALK, anaplastic lymphoma kinase; DIC, disseminated intravascular coagulation; EGFR, epidermal growth factor receptor; ILD, interstitial lung disease; PD, progressive disease; PR, partial response; SD, stable disease; TE, thromboembolism.