Incidence of pulmonary embolism and impact on mortality in patients with malignant melanoma

被引:4
作者
Rennebaum, Shereen [1 ]
Schneider, Stefan W. [2 ]
Henzler, Thomas [1 ]
Desch, Anna [3 ]
Weiss, Christel [4 ]
Haubenreisser, Holger [1 ]
Goerdt, Sergij [5 ]
Morelli, John N. [6 ]
Utikal, Jochen S. [5 ]
Schoenberg, Stefan O. [1 ]
Riffel, Julia [1 ]
机构
[1] Heidelberg Univ, Med Fac Mannheim, Inst Clin Radiol & Nucl Med, Mannheim, Germany
[2] Univ Hosp Hamburg Eppendorf, Dermatol Clin, Hamburg, Germany
[3] Univ Med Ctr Mainz, Dept Dermatol Venereol & Allergol, Mainz, Germany
[4] Heidelberg Univ, Med Stat, Mannheim, Germany
[5] Ruprecht Karl Univ Heidelberg, Univ Med Ctr Mannheim, Dept Dermatol Venereol & Allergol, Mannheim, Germany
[6] Johns Hopkins Univ, Sch Med, Dept Radiol & Radiol Sci, Baltimore, MD USA
关键词
Malignant melanoma; Pulmonary embolism; Computed tomography; Clinical symptoms; Mortality; VON-WILLEBRAND-FACTOR; COMPUTED-TOMOGRAPHY; RISK-FACTORS; THROMBOEMBOLISM; THROMBOSIS; TRIAL; EPIDEMIOLOGY; COAGULATION; PREVALENCE; ACTIVATION;
D O I
10.1016/j.clinimag.2021.12.012
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: Pulmonary embolism (PE) occurs frequently in patients with malignant melanoma (MM). The aim of this study is to determine the incidence of PE in patients with MM and to assess the clinical characteristics and mortality of MM patients with PE. Material and methods: Medical records from 381 MM patients who underwent contrast-enhanced computed tomography were evaluated. Imaging parameters including location of PE and measurements of right heart dysfunction and clinical parameters including D-Dimer levels, local and distant tumor stage and time of death were analyzed. Results: PE was found in 23/381 (6%) MM patients, whereby 17/23 (74%) were detected incidentally and only 6/23 (26%) were symptomatic. The presence of PE significantly correlated with elevated D-Dimers (p < 0.001), right ventricular dysfunction (p = 0.04), higher local tumor stage (>= T3) (p = 0.05), presence of visceral (p = 0.02) or cerebral metastases (p = 0.03) and increased mortality (p = 0.05). Further, patients with central PE showed an increased mortality compared to peripheral PE (p = 0.03), but no correlation was found between the localization of PE and the occurrence of clinical symptoms (p = 0.36). Conclusion: PE in patients with MM often occurs without clinical symptoms and is indicative for advanced disease and a poorer prognosis.
引用
收藏
页码:72 / 76
页数:5
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