Hémoptysies graves des cancers bronchiques

Hemoptysis is frequent in lung cancer, revealing the tumor in 7 to 10% of cases, and involving as much as 20% of patients with lung cancer during disease natural history. Thus, lung cancer is the cause of 10 to 34% of hemoptysis and 6 to 10% of severe bronchial haemorrhage. In massive hemoptysis associated to lung cancer, fatal issue occurs in as much as 50% of cases. Since the wide use of interventional vascular radiology, hemoptysis mortality decreased to 5-20%. 102 patients with severe hemoptysis associated with lung cancer were treated in Pulmonary medicine Department of Tenon University Hospital, Paris in last decade. After multidetector-row CT angiography allowing correct identification of the vascular network involved in the tumor vascularization (either systemic or pulmonary arterial supply), bronchial artery embolization led to a 75% control of pulmonary haemorrhage as previously published. 61% of patients in whom hemoptysis was controlled were able to receive an anticancer treatment, some of them showing prolonged survival even though they initially had metastatic disease. Besides, in our study, overall survival was 45% at 6 months and 31% one year after their discharge from the specialized pulmonary unit.