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Impact of cancer on the prevalence, management, and outcome of patients with chronic thromboembolic pulmonary hypertension

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Abstract

Introduction

Chronic thromboembolic pulmonary hypertension (CTEPH) results from unresolved thrombotic obstruction of the pulmonary vasculature. Cancer is a known risk factor for CTEPH. This study aimed to determine the impact of cancer on the prevalence, management, and outcomes of patients with CTEPH.

Materials and methods

In this retrospective study involving 99 patients sequentially diagnosed with CTEPH in our hospital, the prevalence of 10 comorbid conditions including a past history of cancer at the time of CTEPH diagnosis were calculated.

Results

Among the 99 patients, 17 (17%) had a history of cancer. Breast cancer (n = 6) was the most common cancer type, followed by gastrointestinal cancer (n = 3), uterine cancer (n = 2), and malignant lymphoma (n = 2). Between patients with and without cancer, there were no differences in the demographics, severity of CTEPH, and management; however, the 5-year survival rate was lower for patients with cancer (65%) than for those without (89%). In addition, patients with cancer had significantly worse survival than those without (p = 0.03 by log-rank test). During follow-up, nine patients developed cancer after the diagnosis of CTEPH. Among the 99 patients, 13 died during follow-up, 6 (46%) of whom died of cancer.

Conclusions

17% of our patients with CETPH were diagnosed with cancer, with breast and gastrointestinal tract cancers being the most common. Cancer comorbidity was associated with a poor prognosis and contributed to death in 46% of deceased patients. The impact of cancer on CTEPH should be further evaluated in the future.

Key points

  • In the CTEPH cohort, 17% had a history of cancer, with breast and gastrointestinal tract cancers being the most common.

  • Of the 99 patients, 9 (9%) developed cancer after CTEPH diagnosis, indicating the need for careful cancer surveillance in patients with CTEPH during follow-up.

  • Cancer comorbidity was associated with a poor prognosis and contributed to death in 43% of deceased patients.

  • Future studies should evaluate the impact of cancer on CTEPH.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, 060-8638, Japan

    Junichi Nakamura, Ichizo Tsujino, Hideki Shima, Toshitaka Nakaya, Ayako Sugimoto, Takahiro Sato, Taku Watanabe, Hiroshi Ohira, Masaru Suzuki & Satoshi Konno

  2. Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Hokkaido, Japan

    Ichizo Tsujino, Takahiro Sato & Satoshi Konno

  3. Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, 060-8638, Japan

    Isao Yokota

Authors
  1. Junichi Nakamura
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  2. Ichizo Tsujino
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Contributions

Conceptualization: JN, IT, TS; Methodology: JN, IT, TS; Formal analysis and investigation: JN, HS, TN, AS, TW, HO, IY; Writing - original draft preparation: JN; Writing - review and editing: IT, MS, SK; Funding acquisition: NA; Resources: NA; Supervision: SK.

Corresponding author

Correspondence to Ichizo Tsujino.

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Conflict of interest

IT, TS, and SK received research funding from Nihon Shinyaku Co. Ltd., Nippon Boehringer Ingelheim Co. Ltd., and Mochida Pharmaceutical Co. Ltd. JN, HS, TN, AS, TW, HO, MS, IY declare no conflicts of interest.

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Nakamura, J., Tsujino, I., Shima, H. et al. Impact of cancer on the prevalence, management, and outcome of patients with chronic thromboembolic pulmonary hypertension. J Thromb Thrombolysis 56, 588–593 (2023). https://doi.org/10.1007/s11239-023-02868-w

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  • DOI: https://doi.org/10.1007/s11239-023-02868-w

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