{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T21:04:02Z","timestamp":1776978242399,"version":"3.51.4"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) has improved after the availability of balloon pulmonary angioplasty (BPA) and approved drugs. However, the clinical effects of cancer, which is one of the associated medical conditions of CTEPH, remain unclear. We aimed to investigate prognosis in patients with CTEPH and comorbid cancer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between January 2011 and December 2022, data of 264 consecutive patients with CTEPH who were treated with pulmonary endarterectomy, BPA, or medical therapy were retrospectively analyzed. The patients were allocated, based on the comorbidity of cancer as of December 2022, into the cancer (<jats:italic>n<\/jats:italic>\u2009=\u200947) and non-cancer (<jats:italic>n<\/jats:italic>\u2009=\u2009217) groups. In the cancer group, active and non-active cancers were identified in 30 (64%) and 17 (36%) patients, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The baseline characteristics, hemodynamics, and treatments were similar between the groups. More than half of the cancer were diagnosed within two years before or after CTEPH diagnosis. Twenty-seven patients died during the study period. Among them, 13 (48%) and 7 (26%) died of cancer and right heart failure, respectively. The 5-year survival rate was lower in the cancer group than in the non-cancer group (67.8% vs. 94.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the active cancer group, the 5-year survival rate was also lower than that in the non-active cancer and non-cancer groups (52.0% vs. 99.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and 52.0% vs. 92.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively). Multivariate Cox hazard analysis revealed that hemodialysis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and cancer (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were independently associated with poor survival.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Patients with CTEPH rarely die of right heart failure, even if hemodynamically severe at diagnosis in the modern management era. However, patients with CTEPH frequently have comorbid cancer, which may be a strong prognostic factor.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12890-024-03460-5","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T01:15:15Z","timestamp":1735866915000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between the prognosis and comorbidity of active cancer in chronic thromboembolic pulmonary hypertension"],"prefix":"10.1186","volume":"25","author":[{"given":"Hiroyuki","family":"Fujii","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachiyo","family":"Yoneda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Yanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Emoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken-ichi","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromasa","family":"Otake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"3460_CR1","doi-asserted-by":"publisher","first-page":"1801915","DOI":"10.1183\/13993003.01915-2018","volume":"53","author":"NH Kim","year":"2019","unstructured":"Kim NH, Delcroix M, Jais X, Madani MM, Matsubara H, Mayer E, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J. 2019;53:1801915.","journal-title":"Eur Respir J"},{"key":"3460_CR2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1183\/09059180.00007309","volume":"19","author":"M Humbert","year":"2010","unstructured":"Humbert M. Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: pathophysiology. Eur Respir Rev. 2010;19:59\u201363.","journal-title":"Eur Respir Rev"},{"key":"3460_CR3","doi-asserted-by":"publisher","first-page":"160112","DOI":"10.1183\/16000617.0112-2016","volume":"26","author":"G Simonneau","year":"2017","unstructured":"Simonneau G, Torbicki A, Dorfm\u00fcller P, Kim N. The pathophysiology of chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26:160112.","journal-title":"Eur Respir Rev"},{"key":"3460_CR4","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1378\/chest.81.2.151","volume":"81","author":"M Riedel","year":"1982","unstructured":"Riedel M, Stanek V, Widimsky J, Prerovsky I. Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest. 1982;81:151\u20138.","journal-title":"Chest"},{"key":"3460_CR5","doi-asserted-by":"publisher","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","volume":"43","author":"M Humbert","year":"2022","unstructured":"Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43:3618\u2013731.","journal-title":"Eur Heart J"},{"key":"3460_CR6","unstructured":"Lankeit M, Krieg V, Hobohm L, K\u00f6lmel S, Liebetrau C, Konstantinides S et al. Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension. J Heart Lung Transpl. 2017; S1053-2498(17)31877-6."},{"key":"3460_CR7","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.ijcard.2020.10.026","volume":"326","author":"Y Taniguchi","year":"2021","unstructured":"Taniguchi Y, Matsuoka Y, Onishi H, Yanaka K, Emoto N, Nakai H, et al. The role of balloon pulmonary angioplasty and pulmonary endarterectomy: is chronic thromboembolic pulmonary hypertension still a life-threatening disease? Int J Cardiol. 2021;326:170\u20137.","journal-title":"Int J Cardiol"},{"key":"3460_CR8","doi-asserted-by":"crossref","unstructured":"Heit JA, Silverstein MD, Mohr DN, Petterson TM, O\u2019Fallon WM, Melton LJ 3. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med. 2000;160:809\u201315.","DOI":"10.1001\/archinte.160.6.809"},{"key":"3460_CR9","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1183\/09031936.00087608","volume":"33","author":"D Bonderman","year":"2009","unstructured":"Bonderman D, Wilkens H, Wakounig S, Sch\u00e4fers HJ, Jansa P, Lindner J, et al. Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2009;33:325\u201331.","journal-title":"Eur Respir J"},{"issue":"Suppl 2","key":"3460_CR10","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/S0049-3848(10)00227-6","volume":"125","author":"GC Connolly","year":"2010","unstructured":"Connolly GC, Khorana AA. Emerging risk stratification approaches to cancer-associated thrombosis: risk factors, biomarkers and a risk score. Thromb Res. 2010;125(Suppl 2):S1\u20137.","journal-title":"Thromb Res"},{"key":"3460_CR11","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1007\/s11239-023-02868-w","volume":"56","author":"J Nakamura","year":"2023","unstructured":"Nakamura J, Tsujino I, Shima H, Nakaya T, Sugimoto A, Sato T, et al. Impact of cancer on the prevalence, management, and outcome of patients with chronic thromboembolic pulmonary hypertension. J Thromb Thrombolysis. 2023;56:588\u201393.","journal-title":"J Thromb Thrombolysis"},{"key":"3460_CR12","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1183\/13993003.01032-2015","volume":"46","author":"N Gali\u00e8","year":"2015","unstructured":"Gali\u00e8 N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC\/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Respir J. 2015;46:903\u201375.","journal-title":"Eur Respir J"},{"key":"3460_CR13","doi-asserted-by":"publisher","first-page":"2493","DOI":"10.1093\/eurheartj\/ehp297","volume":"30","author":"N Gali\u00e8","year":"2009","unstructured":"Gali\u00e8 N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009;30:2493\u2013537.","journal-title":"Eur Heart J"},{"key":"3460_CR14","doi-asserted-by":"publisher","first-page":"1891","DOI":"10.1111\/jth.14219","volume":"16","author":"AA Khorana","year":"2018","unstructured":"Khorana AA, Noble S, Lee AYY, Soff G, Meyer G, O\u2019Connell C, et al. Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH. J Thromb Haemost. 2018;16:1891\u201394.","journal-title":"J Thromb Haemost"},{"key":"3460_CR15","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1161\/CIRCULATIONAHA.115.016522","volume":"133","author":"M Delcroix","year":"2016","unstructured":"Delcroix M, Lang I, Pepke-Zaba J, Jansa P, D\u2019Armini AM, Snijder R, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. Circulation. 2016;133:859\u201371.","journal-title":"Circulation"},{"key":"3460_CR16","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1161\/01.CIR.103.1.10","volume":"103","author":"JA Feinstein","year":"2001","unstructured":"Feinstein JA, Goldhaber SZ, Lock JE, Ferndandes SM, Landzberg MJ. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation. 2001;103:10\u20133.","journal-title":"Circulation"},{"key":"3460_CR17","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1161\/CIRCINTERVENTIONS.112.971077","volume":"5","author":"H Mizoguchi","year":"2012","unstructured":"Mizoguchi H, Ogawa A, Munemasa M, Mikouchi H, Ito H, Matsubara H. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012;5:748\u201355.","journal-title":"Circ Cardiovasc Interv"},{"key":"3460_CR18","doi-asserted-by":"publisher","first-page":"e004029","DOI":"10.1161\/CIRCOUTCOMES.117.004029","volume":"10","author":"A Ogawa","year":"2017","unstructured":"Ogawa A, Satoh T, Fukuda T, Sugimura K, Fukumoto Y, Emoto N, et al. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: results of a multicenter registry. Circ Cardiovasc Qual Outcomes. 2017;10:e004029.","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"3460_CR19","doi-asserted-by":"publisher","first-page":"1802095","DOI":"10.1183\/13993003.02095-2018","volume":"53","author":"P Brenot","year":"2019","unstructured":"Brenot P, Ja\u00efs X, Taniguchi Y, Garcia Alonso C, Gerardin B, Mussot S, et al. French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2019;53:1802095.","journal-title":"Eur Respir J"},{"key":"3460_CR20","doi-asserted-by":"publisher","first-page":"1602409","DOI":"10.1183\/13993003.02409-2016","volume":"49","author":"KM Olsson","year":"2017","unstructured":"Olsson KM, Wiedenroth CB, Kamp JC, Breithecker A, Fuge J, Krombach GA, et al. Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension: the initial German experience. Eur Respir J. 2017;49:1602409.","journal-title":"Eur Respir J"},{"key":"3460_CR21","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.4244\/EIJ-D-21-00230","volume":"17","author":"S Darocha","year":"2022","unstructured":"Darocha S, Roik M, Kope\u0107 G, Araszkiewicz A, Furdal M, Lewandowski M, et al. Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: a multicentre registry. EuroIntervention. 2022;17:1104\u201311.","journal-title":"EuroIntervention"},{"key":"3460_CR22","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.healun.2019.04.006","volume":"38","author":"Y Taniguchi","year":"2019","unstructured":"Taniguchi Y, Ja\u00efs X, Jevnikar M, Boucly A, Weatherald J, Brenot P, et al. Predictors of survival in patients with not-operated chronic thromboembolic pulmonary hypertension. J Heart Lung Transpl. 2019;38:833\u201342.","journal-title":"J Heart Lung Transpl"},{"key":"3460_CR23","doi-asserted-by":"publisher","first-page":"1973","DOI":"10.1161\/CIRCULATIONAHA.110.015008","volume":"124","author":"J Pepke-Zaba","year":"2011","unstructured":"Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011;124:1973\u201381.","journal-title":"Circulation"},{"key":"3460_CR24","first-page":"1128","volume":"109","author":"C Englisch","year":"2024","unstructured":"Englisch C, Moik F, Thaler J, Koder S, Mackman N, Preusser M, et al. Tissue factor pathway inhibitor is associated with risk of venous thromboembolism and all-cause mortality in patients with cancer. Haematologica. 2024;109:1128\u201336.","journal-title":"Haematologica"},{"key":"3460_CR25","first-page":"78","volume":"4","author":"M Karimi","year":"2010","unstructured":"Karimi M, Cohan N. Cancer-associated thrombosis. Open Cardiovasc Med J. 2010;4:78\u201382.","journal-title":"Open Cardiovasc Med J"},{"key":"3460_CR26","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/j.jacc.2015.07.025","volume":"66","author":"W Li","year":"2015","unstructured":"Li W, Croce K, Steensma DP, McDermott DF, Ben-Yehuda O, Moslehi J. Vascular and metabolic implications of novel targeted cancer therapies: focus on kinase inhibitors. J Am Coll Cardiol. 2015;66:1160\u201378.","journal-title":"J Am Coll Cardiol"},{"key":"3460_CR27","doi-asserted-by":"publisher","first-page":"4902","DOI":"10.1182\/blood-2007-10-116327","volume":"111","author":"AA Khorana","year":"2008","unstructured":"Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902\u20137.","journal-title":"Blood"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-024-03460-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-024-03460-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-024-03460-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T02:03:45Z","timestamp":1735869825000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-024-03460-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,2]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3460"],"URL":"https:\/\/doi.org\/10.1186\/s12890-024-03460-5","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,2]]},"assertion":[{"value":"20 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Ethics Committee of Kobe University Hospital (approval number: B230114). All enrolled patients were provided with the option to opt out if they did not wish to participate. The requirement for written informed consent was waived because the data were retrospectively collected.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2"}}