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

J Thromb Thrombolysis. 2023 Nov;56(4):588-593. doi: 10.1007/s11239-023-02868-w. Epub 2023 Aug 24.

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.

Keywords: Breast cancer; Cause of death; Gastrointestinal tract; Survival.

MeSH terms

  • Chronic Disease
  • Humans
  • Hypertension, Pulmonary* / diagnosis
  • Hypertension, Pulmonary* / epidemiology
  • Hypertension, Pulmonary* / etiology
  • Neoplasms* / complications
  • Neoplasms* / epidemiology
  • Neoplasms* / therapy
  • Prevalence
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / epidemiology
  • Pulmonary Embolism* / therapy
  • Retrospective Studies