BACKGROUND The management of chronic thromboembolic pulmonary hypertension (CTEPH) has advanced significantly in recent years, thereby improving patient prognosis. However, the impact of cancer on the outcomes of patients with CTEPH under current treatment remains unclear. This study aimed to investigate the prevalence of cancer in patients with CTEPH and determine how comorbid cancer affects their prognosis and clinical course. METHODS Data from an ongoing Japanese prospective cohort study were analyzed. Prevalence and primary cancer sites were evaluated. The association of a history of cancer with a composite endpoint, including all-cause death, lung transplantation, and worsening of CTEPH, as well as venous thromboembolism and bleeding events, was assessed. RESULTS Of the 1,270 patients in the cohort, 134 (10.6%) had a history of cancer, with the most common primary sites being the breast in women and the prostate in men. The incidence of composite outcome and all-cause death was higher in those with a history of cancer (p<0.001, log-rank test). In the Cox proportional hazard model, age- and sex-adjusted hazard ratios for the composite outcome and all-cause death were 2.69 (95% confidence interval, 1.48-4.89, p=0.001) and 4.25 (95% confidence interval, 1.98-9.10, p<0.001), respectively, for patients with a history of cancer. No significant differences in venous thromboembolism and bleeding events were observed between patients with and those without a history of cancer. CONCLUSIONS A history of cancer, with a prevalence of 10.6%, is an independent risk factor for mortality in patients with CTEPH undergoing the currently recommended treatment.

中文翻译：

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癌症是慢性血栓栓塞性肺动脉高压的独立死亡风险。


背景 近年来，慢性血栓栓塞性肺动脉高压 （CTEPH） 的管理取得了显着进展，从而改善了患者的预后。然而，癌症对当前治疗下 CTEPH 患者预后的影响仍不清楚。本研究旨在调查 CTEPH 患者癌症的患病率，并确定共病癌症如何影响其预后和临床病程。方法 分析了来自正在进行的日本前瞻性队列研究的数据。评估患病率和原发癌症部位。评估癌症病史与复合终点的关联，包括全因死亡、肺移植和 CTEPH 恶化，以及静脉血栓栓塞和出血事件。结果 在该队列的 1,270 名患者中，134 名 （10.6%） 有癌症病史，最常见的原发部位是女性的乳房和男性的前列腺。有癌症病史者复合结局和全因死亡的发生率较高 （p<0.001，log-rank 检验）。在 Cox 比例风险模型中，复合结局和全因死亡的年龄和性别调整风险比分别为 2.69 （95% 置信区间，1.48-4.89，p=0.001） 和 4.25 （95% 置信区间，1.98-9.10，p<0.001），对于有癌症病史的患者。在癌症患者和无癌症病史的患者之间未观察到静脉血栓栓塞和出血事件的显著差异。结论 癌症病史（患病率为 10.6%）是接受目前推荐治疗的 CTEPH 患者死亡的独立危险因素。