High risk of deep vein thrombosis in patients with non-small cell lung cancer: A cohort study of 493 patients

Introduction: The risk of symptomatic deep vein thrombosis (DVT) among patients with non-small cell lung cancer (NSCLC) has not been well studied. We conducted a retrospective cohort study of patients with NSCLC to determine the incidence of DVT and to characterize predictors of DVT in patients with NSCLC, Methods: The pulmonary oncology database of the Sir Mortimer B. Davis-Jewish General Hospital contains prospectively collected clinical data on lung cancer patients since January 1, 1997. We identified all consecutive patients with histologically confirmed new diagnoses of NSCLC between January 1, 1997 and December 3 1, 2004, and we determined the occurrence of an objectively defined DVT. Data on clinical and tumor characteristics were collected and compared among patients with DVT and patients without DVT. Results: Of the 493 NSCLC patients included in the cohort for a total of 634 person-years, 67 (13.6%) patients developed objectively confirmed DVTs, with an incidence of I 10 cases (95% confidence interval [CI] 80, 130) per 1000 person-years. An adjusted multivariable regression analysis showed that advanced stage (rate ratio [RR] 2.63, 95% Cl 1.38, 5.00) and male sex (RR 1.75, 95% C1 1.03-2.94) were independent predictors of DVT. Conclusions: Our results show a high incidence of DVT in NSCLC patients. Advanced stage and, to a lesser extent, male sex, are important predictors of DVT. Trials to evaluate the use of prophylactic anticoagulant treatments in patients with NSCLC should be conducted.