Evaluation of Thromboembolism Risk in Patients with Cancer; Single Center Real-life Data

Introduction: Venous thromboembolism (VTE) is an important cause of mortality and morbidity in cancer patients. Both cancer itself and its treatment have been reported to result in an increased risk of VTE. Several scoring systems have been developed to predict cancer-associated VTE risk. The aim of this study was to prospectively test the validity of the Khorana thrombosis score in predicting the risk of VTE development in cancer outpatients at a single centre. Methods: One hundred and fifty-two consecutive patients diagnosed with cancer and scheduled to receive outpatient chemotherapy at University of Health Sciences Turkey, Istanbul Training and Research Hospital between August 2012 and August 2013 were included in the study. Khorana risk scores were calculated for each patient at study entry. Patients were then followed up for at least 24 months after diagnosis or until VTE developed. Results: Thrombosis was detected in 13 of the 152 patients following cancer diagnosis. The median time from diagnosis to thrombosis was 4 months (1-48 months). Thrombosis was of venous and arterial origin in 7 and 6 patients, respectively. The Khorana score failed to differentiate high-risk patients. Scores in patients with and without venous thrombosis were not statistically different (p=0.38). Conclusion: It is important to identify cancer patients at high risk for VTE to decrease the thrombosis-associated dismal outcome. However, in an outpatient setting, the Khorana score failed to differentiate the target population. This could be partly explained by the heterogeneity and the relatively small number of patients included.