N3 nodal staging among patients with non-small cell lung cancer (NSCLC) was associated with a significantly higher risk for developing venous thromboembolism (VTE) compared with N0-N2 staging, a study published in the journal Lung Cancer has shown.1

Although patients with NSCLC are known to be at high risk for VTE, previous studies have not specifically evaluated locally advanced disease.

Therefore, researchers sought to retrospectively assess the VTE risk in a cohort of patients with locally advanced NSCLC who received therapy with definitive intent, including radiotherapy.

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For the study, researchers analyzed data from 629 patients with stage 2 or 3 NSCLC who received care at a single institution between 2003 and 2012. All patients received treatment with curative intent, including radiation therapy.

Of those, 127 patients developed a VTE after a median follow-up of 31 months, with 80% of VTEs occurring in the first 12 months after treatment initiation.

Researchers estimated that the 1-year and 3-year overall cumulative incidence of VTE among patients with locally advanced NSCLC was 13.5% and 15.4%, respectively.

Results showed that N3 nodal disease and stage 3B disease were associated with higher VTE risk; however, after accounting for death and distant metastasis as competing risks, only N3 nodal disease continued to be associated with an increased risk for developing VTE (HR, 1.64; 95% CI: 1.06-2.54; P=.027).


1. Li R, Hermann G, Baldini E, et al. Advanced nodal stage predicts venous thromboembolism in patients with locally advanced non-small cell lung cancer [published online ahead of print March 16, 2016]. Lung Cancer. doi:10.1016/j.lungcan.2016.03.004.