Abstract Number: PB2175
Meeting: ISTH 2020 Congress
Background: Scores has been proposed to predicting incidence of cancer‐associated venous thromboembolism (CAT) among patients starting chemotherapy.
Aims: Evaluate the performance of the Khorana, PROTECHT, and Vienna scores to predict venous thrombosis in a cohort of cancer patients.
Methods: In a prospective multicenter cohort study on Unicamp, CAISM and Hospital de Clínicas, SP, Brazil, patients newly-diagnosed with moderated to advanced cancer (stage II or III solid cancer) were eligible in the absence of chemotherapy or had started chemotherapy in the previous three months.
Results: A total of 429 patients were enrolled (Table 1), of whom 83 (20%) had not yet received chemotherapy. Fourteen patients (3.3%) developed CAT (64.3% DVT and 35.7% PE) with all cases occurring in the 6-months of analysis. The scores classified 12.9% vs. 23.2% of patients as high-risk, 58.6% vs. 57.2% as intermediate-risk, and 28.5% vs. 19.6% as low-risk for Khorana and PROTECHT, respectively. Of the patients with VTE in the first six months, only 13% and 23% had been classified as high risk according to the Khorana and PROTECHT scores. In a preliminary result 80/429 (19%) patients were also evaluated according to VIENNA CATs score. Among three scores VIENNA CATs appears to discriminate better between low- and high-risk patients (Figure 1). The agreement evaluation among three scores was -0.048 (no agreement) according to Kappa coefficient.
Conclusions: Khorana and PROTECHT scores performed poorly in predicting VTE in cancer patients in this population and present no agreement. However, the biomarkers D-Dimer and P-selectine used to calculate VIENNA CATs appear to be important to classify at a risk, since this score presented a high prediction value. Further inclusion of patients to validate this result are needed considering before they can be considered for introduction into clinical practice.
|Variable||CAT Patient (N=14)||Cancer Patient (N=415)|
|Age||52 (31-78)||56 (18-92)|
|Cancer Stage (%)||Stage IV (55%)||Stage II (40%)|
|Cancer site – Higher frequency (%)||Stomach (30%)||Mama (30%)|
|Gemcitabine Chemotherapy (%)||0||07|
|Platina Chemotherapy (%)||05||90|
|P-selectina (ng/L)||59 (14-100)||36 (0-100)|
|D-dimer (ug/L)||2 (0-25)||0 (0-9)|
[Table 1. Demographic data and risk prediction scores for venous thromboembolism in cancer patients.]
To cite this abstract in AMA style:Evelyn Alves de Almeida M, da Silva Souza Gois G, Ramires Rodrigues Alencar T, Aparecida de Lima Montalvão S, Moraes Martinelli B, Macedo Toni I, Barreto Carvalheira J, Etchebehere M, Adami Andreollo N, Cesar Teixeira J, Maria Annichino-Bizzacchi J, ADVENTH Cancer Investigators . No Agreement among Risk Prediction Scores for Venous Thromboembolism in Cancer Patients: A Prospective Cohort Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/no-agreement-among-risk-prediction-scores-for-venous-thromboembolism-in-cancer-patients-a-prospective-cohort-study/. Accessed December 5, 2021.
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