Association of Baseline Serum Uric Acid With Venous Thromboembolism and Clinical Outcomes in Patients With Non-Small Cell Lung Cancer.

Objective: This study aimed to analyze the association between baseline serum uric acid (SUA) level and venous thromboembolism (VTE) and clinical outcomes in patients with non-small cell lung cancer (NSCLC).

Materials and methods: We conducted a prospective analysis of 626 patients with newly diagnosed or recurrent/progressive NSCLC between September 2021 and August 2024. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff values for risk factors related to VTE, and clinical characteristics and treatment outcomes were collected and compared according to these values. Fine-Gray regression analyses were used to identify the risk factors of VTE, and survival was analyzed using log-rank test and Cox regression analysis.

Results: In the study, 72 patients (11.50%) experienced VTE. Patients with VTE had a higher baseline SUA level than those without VTE (p = 0.000). The optimal threshold of baseline SUA to predict VTE was 310 μmol/L. The incidence of VTE was higher in the high SUA group than that of the low SUA group (19.1% vs. 7.9%, p < 0.001). In multivariable analysis, the baseline SUA level was associated with the risk of VTE (sub-distribution hazard ratio (SHR) = 2.830, 95% CI 1.689-4.742, p = 0.000). Additionally, the higher SUA level was associated with a worse disease-free survival (DFS) in newly diagnosed patients with NSCLC staged I-IIIA (adjusted HR = 1.948, 95% CI 1.121-3.384, p = 0.018).

Conclusions: Among NSCLC patients, a baseline feature of high SUA (≥ 310 μmol/L) was associated with an increased risk of VTE and a worse clinical outcome.