Abstract Number: PB2177
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis
Background: Patients with active cancer have a high risk of venous thromboembolism (VTE) during the course of their disease. However, prophylactic treatment is challenging due to a concomitant high risk of bleeding, and development of prediction models to enable assessment of a beneficial balance between thrombosis and bleeding risk are important.
Aims: To test whether a simple risk assessment model for cancer-related VTE based on cancer site, metastasis and genetic information could be used to identify patients at high risk of VTE.
Methods: We used a case-cohort derived from two Norwegian population-based cohorts (Tromsø study and Nord-Trøndelag Health Study). All patients with VTE within one year after cancer diagnosis (n=131) and a randomly sampled subcohort of cancer patients (n=1290) were included. We created a risk score model for one-year prediction of cancer-related VTE based on cancer site (high-, moderate- and low risk= 0/1/2 points) and metastasis (distant=1 point), and a second model adding prothrombotic genotypes (5-SNPs). Cox regression models were used to estimate hazard ratios for VTE with 95% confidence intervals, and Harrel’s C was calculated to determine the discriminatory power.
Results: The simple model containing cancer site and metastasis ranged from 0-3 points, with a HR of VTE per point increase of 2.04 (95% CI: 1.68-2.47). The Harrel’s C was 0.67 (95% CI: 0.62-0.71), and the one-year cumulative incidence of VTE for those with 0,1,2 and 3 points were 1.1%, 1.5%, 2.9% and 4.9%, respectively. Adding the 5-SNP genetic risk score did not change the discriminatory power of the model (Harrel’s C: 0.67, 95% CI: 0.63-0.72).
Conclusions: A simple risk score based on cancer site and metastasis could be used to assess risk of VTE in cancer patients. Addition of prothrombotic genotypes to the model did not improve the discriminatory power.
To cite this abstract in AMA style:
Braekkan SK, Gabrielsen ME, Brumpton B, Hveem K, Hansen J-. Cancer Site and Distant Metastasis at Diagnosis Predict the Risk of VTE in Cancer [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/cancer-site-and-distant-metastasis-at-diagnosis-predict-the-risk-of-vte-in-cancer/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/cancer-site-and-distant-metastasis-at-diagnosis-predict-the-risk-of-vte-in-cancer/