RESEARCH ARTICLE The prognostic impact of additional intrathoracic findings in patients with cancer-related pulmonary embolism P. Jime ´nez-Fonseca 1 • A. Carmona-Bayonas 2 • C. Font 3 • J. Plasencia-Martı ´nez 4 • D. Calvo-Temprano 5 • R. Otero 6 • C. Beato 7 • M. Biosca 8 • M. Sa ´nchez 9 • M. Benegas 9 • D. Varona 10 • L. Faez 1 • M. Antonio 11 • I. de la Haba 12 • O. Madridano 13 • M. P. Solis 1 • A. Ramchandani 14 • E. Castan ˜o ´n 15 • P. J. Marchena 16 • M. Martı ´n 13 • F. Ayala de la Pen ˜a 2 • V. Vicente 2 • On behalf of the EPIPHANY study investigators and the Asociacio ´n de Investigacio ´n de la Enfermedad Tromboembo ´lica de la Regio ´n de Murcia Received: 5 March 2017 / Accepted: 3 July 2017 Ó Federacio ´n de Sociedades Espan ˜olas de Oncologı ´a (FESEO) 2017 Abstract Aim To assess the prevalence and prognostic significance of additional intrathoracic findings (AIFs) in patients with cancer and pulmonary embolism (PE). AIFs were consid- ered alterations other than the characteristic ones intrinsic to PE or changes in cardiovascular morphology. Methods Subjects have been taken from a Spanish national multidisciplinary and multicenter study of PE and cancer who were treated between 2004 and 2015. The endpoint was the appearance of serious complications or death within 15 days. Results The registry contains 1024 eligible patients; 41% diagnosed by computed tomography pulmonary angiogra- phy versus 59% by non-angiographic CT. Serious com- plications occurred within 15 days in 18.9%, [95% confidence interval (CI), 16.6–21.4%] and 9.5% (95% CI 7.9–11.5%) died. At least one AIF was seen in 72.6%. The most common AIFs were as follows: pulmonary nodules (30.9%), pleural effusion (30.2%), tumor progression (28.3%), atelectasis (19.0%), pulmonary infarct (15.2%), emphysema (13.4%), pulmonary lymphangitic carcino- matosis (4.5%), and pneumonia (6.1%). Patients with AIF exhibited a higher complication rate at 15 days: 21.9% versus 13.0%, odds ratio (OR) 1.8 (95% CI 1.2–2.8), P = 0.03, and 15-day mortality: 15.0% versus 7.3%, OR 1.9 (95% CI 1.1–3.2), P = 0.020. Patients with pneumonia, pneumothorax, pulmonary edema, pulmonary nodules, P. Jime ´nez-Fonseca and A. Carmona-Bayonas contributed equally to the work. Electronic supplementary material The online version of this article (doi:10.1007/s12094-017-1713-3) contains supplementary material, which is available to authorized users. & P. Jime ´nez-Fonseca palucaji@hotmail.com 1 Medical Oncology Department, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain 2 Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Murcia, Spain 3 Medical Oncology Department, Hospital Universitari Clinic, Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Barcelona, Spain 4 Radiology Department, Hospital Universitario Morales Meseguer, Murcia, Spain 5 Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain 6 Pneumology Department, Hospital Universitario Virgen del Rocı ´o, CIBER de Enfermedades Respiratorias, Seville, Spain 7 Medical Oncology Department, Hospital Universitario Virgen de la Macarena, Seville, Spain 8 Medical Oncology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain 9 Radiology Department, Hospital Universitari Clı ´nic, Barcelona, Spain 10 Radiology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain 11 Medical Oncology Department, Hospital Duran i Reynals, Institut Catala ` d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain 12 Internal Medicine Department, Hospital Duran i Reynals, Institut Catala ` d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain 13 Internal Medicine Department, Hospital Universitario Infanta Sofı ´a, San Sebastia ´n de los Reyes, Madrid, Spain 123 Clin Transl Oncol DOI 10.1007/s12094-017-1713-3