Unsuspected PE seldom linked to death in cancer patients

M. Sahut D'Izarn, M.D., of the Hôpitaux de Paris, and colleagues conducted a retrospective case-control study involving 132 cancer patients without PE and 65 cancer patients with clinically suspected PE to assess the risk of UPE in cancer patients.

The researchers found that, overall, 40.9 percent of UPE patients had symptoms suggestive of PE. Patients with adenocarcinoma, advanced age, recent chemotherapy, performance status greater than 2, and previous venous thromboembolism were more likely to have UPE. Six-month mortality was not statistically significantly different for patients with UPE compared with those without PE. UPE patients were more likely to have central venous catheters and chemotherapy and less likely to have proximal clots than those with clinically suspected PE. Recurrent venous thromboembolism occurred in 6.1 percent of patients with UPE and 7.7 percent of patients with symptomatic PE.

"In conclusion, in the context of a retrospective study, a high proportion of patients with UPE have respiratory symptoms preceding the diagnosis of PE. This may prompt the attention of the oncologist when a patient at risk for UPE complains of dyspnea or chest pain," the authors write. "The increased mortality rate of patients with UPE seems to be mainly related to their underlying condition and, especially, poor performance status rather than to UPE itself."

One author disclosed financial ties to the pharmaceutical industry.

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