Life expectancy in cancer patients with pulmonary thromboembolism: From clinical prognostic biomarkers and paraclinical investigations to therapeutic approaches (Review)

Nemtut,Daniela Maria; Petreanu,Cornel Adrian; Ulmeanu,Ruxandra; Rajnoveanu,Armand Gabriel; Rajnoveanu,Ruxandra Mioara

doi:10.3892/etm.2024.12643

Life expectancy in cancer patients with pulmonary thromboembolism: From clinical prognostic biomarkers and paraclinical investigations to therapeutic approaches (Review)

Authors:
- Daniela Maria Nemtut
- Cornel Adrian Petreanu
- Ruxandra Ulmeanu
- Armand Gabriel Rajnoveanu
- Ruxandra Mioara Rajnoveanu
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Affiliations: Cardiology Department, Pelican Clinical Hospital, Oradea 410450, Romania, Thoracic Surgery Department, Pneumology Institute Marius Nasta, Bucharest 050159, Romania, Bronchoscopy Department, North Hospital, Provita Medical Group, Bucharest 020335, Romania, Occupational Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj‑Napoca 400012, Romania, Palliative Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj‑Napoca 400012, Romania
Published online on: July 5, 2024 https://doi.org/10.3892/etm.2024.12643
Article Number: 354
Copyright: © Nemtut et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pulmonary embolisms (PEs) are obstructions of the pulmonary arteries by thrombi, which are emboli and they most frequently originate from the deep venous system of the inferior limbs. Emboli can also come from the inferior vena cava, abdominal and pelvic veins, or the upper body venous system from the right atrium or ventricle of the heart. Thrombi can form in situ inside pulmonary arteries as well. A cancer patient is at a higher risk for thromboembolic phenomena given both the oncological pathological context and also due to the associated medical or surgical treatment they receive. PE is a high‑risk medical emergency that is associated with an increased risk of early mortality, with sudden death occurring in 25% of patients. The long‑term presence of this condition can result in thromboembolic pulmonary hypertension. The risk of mortality, both in the acute and long‑term, is dependent on the severity of the acute form, the recurrence of the embolism and the associated conditions. The majority of deaths associated with PE can be prevented by early diagnosis. The aim of the present review was to describe the various biological and cellular parameters, together with known paraclinical investigations, to assist in the rapid diagnosis of PE. Mortality in patients with PE and neoplastic conditions may be reduced by initiating anticoagulant treatment as soon as possible. PE may be the first manifestation of an underlying silent malignancy or may represent a complication of an already diagnosed malignancy. Exclusion or confirmation of the diagnosis is of utmost importance to avoid unnecessary anticoagulant treatment associated with a high risk of bleeding or to start immediate anticoagulant treatment if required.

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