Page 76 - GTM-2-3

Global Translational Medicine Thromboembolism risk in non-small-cell lung cancer

were required, with at least 15% of these tumor cells According to the TNM-8 staging system, 19.5% (n = 67)
displaying split or monopatterned characteristics. of the patients had locally advanced cancers, while 80.5%
(n = 276) had advanced cancers. Multiple metastases
2.4. Diagnosis and classification of VTE (occurring on >2 sides) were present in 61.2% (n = 210) of

Incidentally detected VTE events identified through patients with advanced-stage patients. The distribution of
imaging, regardless of the presence of patient symptoms, molecular mutations included 115 (33.5%) EGFR-mutant
as well as symptomatic VTE events confirmed through patients, 37 (10.8%) ALK-mutant patients, and 190 (55.4%)
radiological assessment prompted by clinical suspicion, patients without any detected mutations.
were both included as TE events.
Occurrences of DVT were identified in 23 patients
The confirmation of deep vein thrombosis (DVT) (6.7%), and PE was observed in 31 patients (9%) within
cases involved venous ultrasound imaging. In instances the entire study population. Among mutation (+) patients,
of PE, confirmation was achieved through computed 8 (5.2%) exhibited DVT, and 22 (14.2%) showed PE.
tomography pulmonary angiography or ventilation- While 30 (19.4%) of 155 patients developed VTE in the
perfusion scanning, chosen based on patients’ history of mutation (+) group, this number was 24 (12.8%) in the
contrast allergy or renal failure. mutation (-) group (P = 0.07). The prevalence of PE was
significantly higher in the mutation (+) group compared
2.5. Statistical analysis
to the mutation (-) group (14.4% vs. 4.7%, P < 0.002).
Categorical data were presented as percentages (%) and There was no statistically significant difference between
absolute numbers, and their comparison was carried the two groups in terms of DVT prevalence (5.2% vs. 7.9%,
out using Chi-square or Fisher’s exact tests. The normal P = 0.32) (Table 1).
distribution of continuous variables was assessed using
the Kolmogorov–Smirnov test. Levene’s test was utilized The median follow-up time for all patients was
to analyze the homogeneity of variances. Continuous 87 months (95% CI: 75.819 – 98.181), 82 months
data were described either as mean±standard deviation (95% CI: 73.328 – 90.672) for mutation (+) patients, and
(SD) or as median (minimum–maximum), based on 95 months (95% CI: 93.570 – 96.430) for mutation (-)
the normality of distribution. The differences between patients.
groups were examined using Student’s t-test and Mann– Overall, 155 patients were administered specific
Whitney U-tests. Univariate and multivariate Cox tyrosine kinase inhibitors (TKI) based on their driver
regression analyses were conducted to assess risk factors mutations. Among these, 148 patients initiated TKI
independently associated with VTE. The multivariate treatment before experiencing VTE, while seven patients
analysis was conducted for variables that demonstrated began TKI treatment after the development of VTE events.
significance (P < 0.05) as per the univariate test. Hazard
ratios (HRs) with corresponding 95% confidence intervals Demographic and clinical characteristics were
(CI) were calculated. The observation time was defined compared between the mutation (+) and mutation (-)
as the period between the date of NSCLC diagnosis groups (Table 1). Both groups exhibited similar age
and the occurrence of VTE, death, or censoring time distribution, clinical stage, gender composition, and
(February 1, 2023). The median OS was determined as presence of multiple metastases. However, the rate of
the duration (in days) from the date of LA diagnosis to PE was significantly higher in the mutation (+) group
either the date of all-cause mortality or the analysis time. (P = 0.002).
The Kaplan–Meier method was employed to estimate Two groups were compared based on laboratory
survival curves for different molecular subtypes (mutation parameters, revealing a statistically significant difference in
[-] and mutation [+]), with a log-rank test employed for D-dimer levels and lymphocyte counts (P = 0.01) (Table 2).
comparisons. The reverse Kaplan–Meier method was used
to estimate median follow-up time. All statistical analyses An analysis of the mutation (+) group failed to yield
were performed using IBM SPSS Statistics for Windows, statistically significant results when EGFR (+) and ALK (+)
Version 25.0 (IBM Corp. Released 2017, Armonk, NY: IBM patients were assessed in terms of VTE (P = 0.9). Similarly,
Corp). P < 0.05 was considered statistically significant. no statistically significant results were observed in terms of
pulmonary thromboembolism (PTE) (P = 0.47).
3. Results The rate of VTE was also investigated within the
A total of 343 patients with locally advanced or advanced subgroups of EGFR exon 19 and exon 21 mutations in our
LA (97 females and 246 males, with a mean age of study. Although statistical significance was not reached, a
61.9 ± 10.6 years) were enrolled in the study. higher PE rate was evident in the exon 21 group (P = 0.22).

Volume 2 Issue 3 (2023) 3 https://doi.org/10.36922/gtm.1027