{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:10:59Z","timestamp":1790637059364,"version":"4.1.0"},"reference-count":27,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"<jats:p>Context.\u2014The causes of death for patients with lung cancer are inadequately described.<\/jats:p>\n                  <jats:p>Objective.\u2014To categorize the immediate and contributing causes of death for patients with lung cancer.<\/jats:p>\n                  <jats:p>Design.\u2014The autopsies from 100 patients who died of lung cancer between 1990 and February 2011 were analyzed.<\/jats:p>\n                  <jats:p>Results.\u2014Tumor burden was judged the immediate cause of death in 30 cases, including 26 cases of extensive metastases and 4 cases with wholly or primarily lung tumor burden (causing respiratory failure). Infection was the immediate cause of death for 20 patients, including 8 with sepsis and 12 with pneumonia. Complications of metastatic disease were the immediate causes of death in 18 cases, including 6 cases of hemopericardium from pericardial metastases, 3 from myocardial metastases, 3 from liver metastases, and 3 from brain metastases. Other immediate causes of death were pulmonary hemorrhage (12 cases), pulmonary embolism (10 cases, 2 tumor emboli), and pulmonary diffuse alveolar damage (7 cases). From a functional (pathophysiologic) perspective, respiratory failure could be regarded as the immediate cause of death (or mechanism of death) in 38 cases, usually because of a combination of lung conditions, including emphysema, airway obstruction, pneumonia, hemorrhage, embolism, resection, and lung injury in addition to the tumor. For 94 of the 100 patients, there were contributing causes of death, with an average of 2.5 contributing causes and up to 6 contributing causes of death.<\/jats:p>\n                  <jats:p>Conclusions.\u2014The numerous and complex ways lung cancer kills patients pose a challenge for efforts to extend and improve their lives.<\/jats:p>","DOI":"10.5858\/arpa.2011-0521-oa","type":"journal-article","created":{"date-parts":[[2012,11,29]],"date-time":"2012-11-29T16:39:50Z","timestamp":1354207190000},"page":"1552-1557","source":"Crossref","is-referenced-by-count":123,"title":["Causes of Death of Patients With Lung Cancer"],"prefix":"10.5858","volume":"136","author":[{"given":"Larry","family":"Nichols","sequence":"first","affiliation":[{"name":"From the Departments of Pathology (Dr Nichols and Ms Saunders) and Radiology (Dr Knollmann), University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Saunders","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Dr Nichols and Ms Saunders) and Radiology (Dr Knollmann), University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich D.","family":"Knollmann","sequence":"additional","affiliation":[{"name":"From the Departments of Pathology (Dr Nichols and Ms Saunders) and Radiology (Dr Knollmann), University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"6","key":"2020081220142588300_i1543-2165-136-12-1552-b01","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/j.1445-5994.2009.02113.x","article-title":"Managing obstruction of the central airways","volume":"40","author":"Williamson","year":"2010","journal-title":"Intern Med J"},{"key":"2020081220142588300_i1543-2165-136-12-1552-b02","first-page":"F1","article-title":"Perhaps death is proud; more reason to savor life","author":"Brown","year":"2008","journal-title":"New York Times. September 9"},{"issue":"3","key":"2020081220142588300_i1543-2165-136-12-1552-b03","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.lungcan.2007.01.022","article-title":"Bronchoscopy for bevacizumab-related hemoptysis","volume":"56","author":"Cho","year":"2007","journal-title":"Lung Cancer"},{"issue":"14","key":"2020081220142588300_i1543-2165-136-12-1552-b04","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.2169\/internalmedicine.49.3296","article-title":"Diffuse liver metastasis of small cell lung cancer causing marked hepatomegaly and fulminant hepatic failure","volume":"49","author":"Miyaaki","year":"2010","journal-title":"Intern Med"},{"issue":"29","key":"2020081220142588300_i1543-2165-136-12-1552-b05","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1200\/JCO.2009.22.4584","article-title":"Impact of venous thromboembolism and anticoagulation on cancer and cancer survival","volume":"27","author":"Kuderer","year":"2009","journal-title":"J Clin Oncol"},{"issue":"7","key":"2020081220142588300_i1543-2165-136-12-1552-b06","doi-asserted-by":"crossref","first-page":"320, 322","DOI":"10.12968\/ijpn.2009.15.7.43421","article-title":"A difficult clinical problem: diagnosis, impact and clinical management of cachexia in palliative care","volume":"15","author":"Holmes","year":"2009","journal-title":"Int J Palliat Nurs"},{"issue":"4","key":"2020081220142588300_i1543-2165-136-12-1552-b07","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.cllc.2011.03.020","article-title":"Comorbidity in lung cancer: important but neglected: a review of the current literature","volume":"12","author":"Grose","year":"2011","journal-title":"Clin Lung Cancer"},{"issue":"2","key":"2020081220142588300_i1543-2165-136-12-1552-b08","doi-asserted-by":"crossref","first-page":"107","DOI":"10.3810\/hp.2011.04.400","article-title":"Treatment of advanced lung cancer in the elderly","volume":"39","author":"Gajra","year":"2011","journal-title":"Hosp Pract (Minneap)"},{"issue":"3","key":"2020081220142588300_i1543-2165-136-12-1552-b09","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1378\/chest.122.3.1037","article-title":"Prognostic factors in non\u2013small cell lung cancer: a decade of progress","volume":"122","author":"Brundage","year":"2002","journal-title":"Chest"},{"issue":"3","key":"2020081220142588300_i1543-2165-136-12-1552-b10","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.lungcan.2009.02.012","article-title":"Impact and interactions between smoking and traditional prognostic factors in lung cancer progression","volume":"66","author":"Guo","year":"2009","journal-title":"Lung Cancer"},{"issue":"5","key":"2020081220142588300_i1543-2165-136-12-1552-b11","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1016\/j.athoracsur.2010.11.065","article-title":"Pathologic lymph node staging practice and stage-predicted survival after resection of lung cancer","volume":"91","author":"Osarogiagbon","year":"2011","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"2020081220142588300_i1543-2165-136-12-1552-b12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0360-3016(01)01772-2","article-title":"Gross tumor volume, critical prognostic factor in patients treated with three-dimensional conformal radiation therapy for non\u2013small-cell lung carcinoma","volume":"52","author":"Bradley","year":"2002","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"2020081220142588300_i1543-2165-136-12-1552-b13","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1016\/j.ijrobp.2009.12.060","article-title":"Tumor volume is a prognostic factor in non\u2013small-cell lung cancer treated with chemoradiotherapy","volume":"79","author":"Alexander","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"2020081220142588300_i1543-2165-136-12-1552-b14","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.ijrobp.2007.04.036","article-title":"Metabolic tumor burden predicts for disease progression and death in lung cancer","volume":"69","author":"Lee","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2020081220142588300_i1543-2165-136-12-1552-b15","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1475-2891-9-69","article-title":"Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature","volume":"9","author":"Gupta","year":"2010","journal-title":"Nutr J"},{"issue":"6","key":"2020081220142588300_i1543-2165-136-12-1552-b16","first-page":"987","article-title":"Retrospective analysis of immediate cause of death in lung cancer-two case reports of lung cancer deaths due to bowel necrosis [in Japanese]","volume":"38","author":"Ogata","year":"2011","journal-title":"Gan To Kagaku Ryoho"},{"issue":"11","key":"2020081220142588300_i1543-2165-136-12-1552-b17","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.1210\/jcem.84.11.6115","article-title":"Immediate causes of death in thyroid carcinoma: clinicopathological analysis of 161 fatal cases","volume":"84","author":"Kitamura","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2020081220142588300_i1543-2165-136-12-1552-b18","first-page":"1755","article-title":"Characteristics and pattern of mortality in cancer patients at a tertiary care oncology center: report of 259 cases","volume":"11","author":"Prakash","year":"2010","journal-title":"Asian Pac J Cancer Prev"},{"issue":"6","key":"2020081220142588300_i1543-2165-136-12-1552-b19","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.2214\/ajr.158.6.1590110","article-title":"CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests","volume":"158","author":"Johkoh","year":"1992","journal-title":"AJR Am J Roentgenol"},{"issue":"14","key":"2020081220142588300_i1543-2165-136-12-1552-b20","doi-asserted-by":"crossref","first-page":"3069","DOI":"10.1002\/cncr.25894","article-title":"Pulmonary toxicity related to systemic treatment of non\u2013small cell lung cancer","volume":"117","author":"DeSanctis","year":"2011","journal-title":"Cancer"},{"issue":"8","key":"2020081220142588300_i1543-2165-136-12-1552-b21","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.3346\/jkms.2010.25.8.1146","article-title":"Emphysema as a risk factor for the outcome of surgical resection of lung cancer","volume":"25","author":"Lee","year":"2010","journal-title":"J Korean Med Sci"},{"issue":"2","key":"2020081220142588300_i1543-2165-136-12-1552-b22","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1440-1843.2010.01907.x","article-title":"The prevalence of pulmonary fibrosis combined with emphysema in patients with lung cancer","volume":"16","author":"Usui","year":"2011","journal-title":"Respirology"},{"issue":"10","key":"2020081220142588300_i1543-2165-136-12-1552-b23","doi-asserted-by":"crossref","first-page":"741","DOI":"10.2459\/JCM.0b013e32834ab683","article-title":"Metastatic tumor of the heart: description of a case","volume":"12","author":"Baratella","year":"2011","journal-title":"J Cardiovasc Med (Hagerstown)"},{"issue":"1","key":"2020081220142588300_i1543-2165-136-12-1552-b24","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/MAJ.0b013e3181b7f190","article-title":"Platypnea-orthodeoxia, an uncommon presentation of patent foramen ovale","volume":"339","author":"Natalie","year":"2010","journal-title":"Am J Med Sci"},{"issue":"2","key":"2020081220142588300_i1543-2165-136-12-1552-b25","doi-asserted-by":"crossref","first-page":"R48","DOI":"10.1186\/cc5782","article-title":"Premortem clinical diagnoses and postmortem autopsy findings: discrepancies in critically ill cancer patients","volume":"11","author":"Pastores","year":"2007","journal-title":"Crit Care"},{"issue":"16","key":"2020081220142588300_i1543-2165-136-12-1552-b26","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1056\/NEJMoa0902234","article-title":"The clinical course of advanced dementia","volume":"361","author":"Mitchell","year":"2009","journal-title":"N Engl J Med"},{"issue":"1","key":"2020081220142588300_i1543-2165-136-12-1552-b27","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/1471-2407-11-353","article-title":"Quality of life assessment as a predictor of survival in non\u2013small cell lung cancer","volume":"11","author":"Braun","year":"2011","journal-title":"BMC Cancer"}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/136\/12\/1552\/2262837\/arpa_2011-0521-oa.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/136\/12\/1552\/2262837\/arpa_2011-0521-oa.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:34:17Z","timestamp":1764790457000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/136\/12\/article-p1552.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12,1]]},"references-count":27,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12,1]]}},"URL":"https:\/\/doi.org\/10.5858\/arpa.2011-0521-oa","relation":{},"ISSN":["1543-2165","0003-9985"],"issn-type":[{"value":"1543-2165","type":"electronic"},{"value":"0003-9985","type":"print"}],"subject":[],"published":{"date-parts":[[2012,12,1]]}}}