Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study

Rammey Hassan; Shuchi Gulati; Yellu Mahender; Ihab Eldessouki; Nabeela Iffat Siddiqi; Changchun Xie; Jane Pruemer; Nagla Abdel Karim

doi:doi:10.11648/j.ajcem.20170505.13

Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study

Rammey Hassan, Shuchi Gulati, Yellu Mahender, Ihab Eldessouki, Nabeela Iffat Siddiqi, Changchun Xie, Jane Pruemer, Nagla Abdel Karim

Published in American Journal of Clinical and Experimental Medicine (Volume 5, Issue 5)

Received: 20 July 2017 Accepted: 14 August 2017 Published: 4 September 2017

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Abstract

Low Molecular Weight Heparin (LMWH) is approved for treatment of and secondary prophylaxis against thromboembolic events in patients with cancer. However, its role in improving Overall Survival (OS) remains unclear. A retrospective study to evaluate effect of LMWH on OS in advanced lung cancer was conducted by retrospectively identifying patients with advanced lung cancer (stage IIIA, IIIB and IV) including non-small cell, small cell and rare histopathologic subtypes from 2004 to 2014. Patients with early stage lung cancer and those with incomplete information were excluded. Data on patient demographics (age, gender, ethnicity), histopathology, staging, medications (including chemotherapy and anticoagulants) and patient outcome were collected. Death was considered as the final endpoint. Patients with and without LMWH use were identified. This study did not find an improvement in OS with use of LMWH in advanced stage lung cancer patients. Even though the results were not statistically significant, there was a trend towards higher mortality in patients treated with LMWH for thrombosis compared to patients without thrombosis. Future prospective studies using a larger patient population should evaluate the impact of prophylactic versus therapeutic LMWH on OS in advanced lung cancer.

Published in	American Journal of Clinical and Experimental Medicine (Volume 5, Issue 5)
DOI	10.11648/j.ajcem.20170505.13
Page(s)	173-175
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Lung Cancer, Low Molecular Weight Heparin, Venous Thromboembolism, Thrombosis

References

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[3]	Bréchot JM. Thrombosis and Lung Cancer, 2005; 22(6 Pt 2): 8S33-7. PMID: 16340833
[4]	Maraveyas A, Johnson M. Does clinical method mask significant VTE-related mortality and morbidity in malignant disease? Br J Cancer. 2009; 100(12): 1837-1841. doi: 10.1038/sj.bjc.6605091.
[5]	Tesselaar ME, Osanto S. Risk of venous thromboembolism in lung cancer. Curr Opin Pulm Med. 2007; 13(5): 362-367. doi: 10.1097/MCP.0b013e328209413c.
[6]	Johnson MJ, Sproule MW, Paul J. The prevalence and associated variables of deep venous thrombosis in patients with advanced cancer. Clin Oncol (R Coll Radiol). 1999; 11(2): 105-110. http://www.ncbi.nlm.nih.gov/pubmed/10378636.
[7]	Khorana AA. Venous thromboembolism and prognosis in cancer. Thromb Res. 2010; 125(6): 490-493. doi: 10.1016/j.thromres.2009.12.023.
[8]	Ogren M, Bergqvist D, Wåhlander K, Eriksson H, Sternby NH. Trousseau’s syndrome - What is the evidence? A population-based autopsy study. Thromb Haemost. 2006; 95(3): 541-545. doi: 10.1160/TH05-10-0694.
[9]	Kakkar AK, Levine MN, Kadziola Z, et al. Low molecular weight heparin, therapy with dalteparin, and survival in advanced cancer: The fragmin advanced malignancy outcome study (FAMOUS). J Clin Oncol. 2004; 22(10): 1944-1948. doi: 10.1200/JCO.2004.10.002.
[10]	Klerk CP, Smorenburg SM, Otten HM, et al. The effect of low molecular weight heparin on survival in patients with advanced malignancy. J Clin Oncol. 2005; 23(10): 2130-2135. doi: 10.1200/JCO.2005.03.134.
[11]	Altinbas M, Coskun HS, Er O, et al. A randomized clinical trial of combination chemotherapy with and without low-molecular-weight heparin in small cell lung cancer. J Thromb Haemost. 2004; 2(8): 1266-1271. doi: 10.1111/j.1538-7836.2004.00871.x.
[12]	Lebeau B, Chastang C, Brechot JM, et al. Subcutaneous heparin treatment increases survival in small cell lung cancer. “Petites Cellules” Group. Cancer. 1994; 74(1): 38-45.

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APA Style

Rammey Hassan, Shuchi Gulati, Yellu Mahender, Ihab Eldessouki, Nabeela Iffat Siddiqi, et al. (2017). Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. American Journal of Clinical and Experimental Medicine, 5(5), 173-175. https://doi.org/10.11648/j.ajcem.20170505.13

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ACS Style

Rammey Hassan; Shuchi Gulati; Yellu Mahender; Ihab Eldessouki; Nabeela Iffat Siddiqi, et al. Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. Am. J. Clin. Exp. Med. 2017, 5(5), 173-175. doi: 10.11648/j.ajcem.20170505.13

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AMA Style

Rammey Hassan, Shuchi Gulati, Yellu Mahender, Ihab Eldessouki, Nabeela Iffat Siddiqi, et al. Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. Am J Clin Exp Med. 2017;5(5):173-175. doi: 10.11648/j.ajcem.20170505.13

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@article{10.11648/j.ajcem.20170505.13,
  author = {Rammey Hassan and Shuchi Gulati and Yellu Mahender and Ihab Eldessouki and Nabeela Iffat Siddiqi and Changchun Xie and Jane Pruemer and Nagla Abdel Karim},
  title = {Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {5},
  number = {5},
  pages = {173-175},
  doi = {10.11648/j.ajcem.20170505.13},
  url = {https://doi.org/10.11648/j.ajcem.20170505.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20170505.13},
  abstract = {Low Molecular Weight Heparin (LMWH) is approved for treatment of and secondary prophylaxis against thromboembolic events in patients with cancer. However, its role in improving Overall Survival (OS) remains unclear. A retrospective study to evaluate effect of LMWH on OS in advanced lung cancer was conducted by retrospectively identifying patients with advanced lung cancer (stage IIIA, IIIB and IV) including non-small cell, small cell and rare histopathologic subtypes from 2004 to 2014. Patients with early stage lung cancer and those with incomplete information were excluded. Data on patient demographics (age, gender, ethnicity), histopathology, staging, medications (including chemotherapy and anticoagulants) and patient outcome were collected. Death was considered as the final endpoint. Patients with and without LMWH use were identified. This study did not find an improvement in OS with use of LMWH in advanced stage lung cancer patients. Even though the results were not statistically significant, there was a trend towards higher mortality in patients treated with LMWH for thrombosis compared to patients without thrombosis. Future prospective studies using a larger patient population should evaluate the impact of prophylactic versus therapeutic LMWH on OS in advanced lung cancer.},
 year = {2017}
}

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TY  - JOUR
T1  - Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study
AU  - Rammey Hassan
AU  - Shuchi Gulati
AU  - Yellu Mahender
AU  - Ihab Eldessouki
AU  - Nabeela Iffat Siddiqi
AU  - Changchun Xie
AU  - Jane Pruemer
AU  - Nagla Abdel Karim
Y1  - 2017/09/04
PY  - 2017
N1  - https://doi.org/10.11648/j.ajcem.20170505.13
DO  - 10.11648/j.ajcem.20170505.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 173
EP  - 175
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20170505.13
AB  - Low Molecular Weight Heparin (LMWH) is approved for treatment of and secondary prophylaxis against thromboembolic events in patients with cancer. However, its role in improving Overall Survival (OS) remains unclear. A retrospective study to evaluate effect of LMWH on OS in advanced lung cancer was conducted by retrospectively identifying patients with advanced lung cancer (stage IIIA, IIIB and IV) including non-small cell, small cell and rare histopathologic subtypes from 2004 to 2014. Patients with early stage lung cancer and those with incomplete information were excluded. Data on patient demographics (age, gender, ethnicity), histopathology, staging, medications (including chemotherapy and anticoagulants) and patient outcome were collected. Death was considered as the final endpoint. Patients with and without LMWH use were identified. This study did not find an improvement in OS with use of LMWH in advanced stage lung cancer patients. Even though the results were not statistically significant, there was a trend towards higher mortality in patients treated with LMWH for thrombosis compared to patients without thrombosis. Future prospective studies using a larger patient population should evaluate the impact of prophylactic versus therapeutic LMWH on OS in advanced lung cancer.
VL  - 5
IS  - 5
ER  -

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Author Information

Rammey Hassan

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA
Shuchi Gulati

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA
Yellu Mahender

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA
Ihab Eldessouki

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA
Nabeela Iffat Siddiqi

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA
Changchun Xie

Division of Biostatistics and Bioinformatics, University of Cincinnati, Cincinnati, USA
Jane Pruemer

James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, USA
Nagla Abdel Karim

Department of Oncology, University of Cincinnati Medical Center, Cincinnati, USA

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APA Style

Rammey Hassan, Shuchi Gulati, Yellu Mahender, Ihab Eldessouki, Nabeela Iffat Siddiqi, et al. (2017). Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. American Journal of Clinical and Experimental Medicine, 5(5), 173-175. https://doi.org/10.11648/j.ajcem.20170505.13

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ACS Style

Rammey Hassan; Shuchi Gulati; Yellu Mahender; Ihab Eldessouki; Nabeela Iffat Siddiqi, et al. Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. Am. J. Clin. Exp. Med. 2017, 5(5), 173-175. doi: 10.11648/j.ajcem.20170505.13

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AMA Style

Rammey Hassan, Shuchi Gulati, Yellu Mahender, Ihab Eldessouki, Nabeela Iffat Siddiqi, et al. Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study. Am J Clin Exp Med. 2017;5(5):173-175. doi: 10.11648/j.ajcem.20170505.13

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@article{10.11648/j.ajcem.20170505.13,
  author = {Rammey Hassan and Shuchi Gulati and Yellu Mahender and Ihab Eldessouki and Nabeela Iffat Siddiqi and Changchun Xie and Jane Pruemer and Nagla Abdel Karim},
  title = {Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {5},
  number = {5},
  pages = {173-175},
  doi = {10.11648/j.ajcem.20170505.13},
  url = {https://doi.org/10.11648/j.ajcem.20170505.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20170505.13},
  abstract = {Low Molecular Weight Heparin (LMWH) is approved for treatment of and secondary prophylaxis against thromboembolic events in patients with cancer. However, its role in improving Overall Survival (OS) remains unclear. A retrospective study to evaluate effect of LMWH on OS in advanced lung cancer was conducted by retrospectively identifying patients with advanced lung cancer (stage IIIA, IIIB and IV) including non-small cell, small cell and rare histopathologic subtypes from 2004 to 2014. Patients with early stage lung cancer and those with incomplete information were excluded. Data on patient demographics (age, gender, ethnicity), histopathology, staging, medications (including chemotherapy and anticoagulants) and patient outcome were collected. Death was considered as the final endpoint. Patients with and without LMWH use were identified. This study did not find an improvement in OS with use of LMWH in advanced stage lung cancer patients. Even though the results were not statistically significant, there was a trend towards higher mortality in patients treated with LMWH for thrombosis compared to patients without thrombosis. Future prospective studies using a larger patient population should evaluate the impact of prophylactic versus therapeutic LMWH on OS in advanced lung cancer.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Impact of Low Molecular Weight Heparin on Overall Survival in Patients with Advanced Lung Cancer: A Retrospective Study
AU  - Rammey Hassan
AU  - Shuchi Gulati
AU  - Yellu Mahender
AU  - Ihab Eldessouki
AU  - Nabeela Iffat Siddiqi
AU  - Changchun Xie
AU  - Jane Pruemer
AU  - Nagla Abdel Karim
Y1  - 2017/09/04
PY  - 2017
N1  - https://doi.org/10.11648/j.ajcem.20170505.13
DO  - 10.11648/j.ajcem.20170505.13
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 173
EP  - 175
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20170505.13
AB  - Low Molecular Weight Heparin (LMWH) is approved for treatment of and secondary prophylaxis against thromboembolic events in patients with cancer. However, its role in improving Overall Survival (OS) remains unclear. A retrospective study to evaluate effect of LMWH on OS in advanced lung cancer was conducted by retrospectively identifying patients with advanced lung cancer (stage IIIA, IIIB and IV) including non-small cell, small cell and rare histopathologic subtypes from 2004 to 2014. Patients with early stage lung cancer and those with incomplete information were excluded. Data on patient demographics (age, gender, ethnicity), histopathology, staging, medications (including chemotherapy and anticoagulants) and patient outcome were collected. Death was considered as the final endpoint. Patients with and without LMWH use were identified. This study did not find an improvement in OS with use of LMWH in advanced stage lung cancer patients. Even though the results were not statistically significant, there was a trend towards higher mortality in patients treated with LMWH for thrombosis compared to patients without thrombosis. Future prospective studies using a larger patient population should evaluate the impact of prophylactic versus therapeutic LMWH on OS in advanced lung cancer.
VL  - 5
IS  - 5
ER  -

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