Utility of the Khorana and the new-Vienna CATS prediction scores in cancer patients of the HYPERCAN cohort
Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Risk assessment models (RAMs) are relevant approaches to identify cancer outpatients at high risk of venous thromboembolism (VTE). Among the proposed RAMs, the Khorana (KRS) and the new-Vienna CATS risk scores have been externally validated in ambulatory patients with cancer.
OBJECTIVES: To test KRS and new-Vienna CATS scores in 6-month VTE prediction and mortality in a large prospective cohort of metastatic cancer outpatients during chemotherapy.
PATIENTS/METHODS: Newly diagnosed patients with metastatic non-small cell lung, colorectal, gastric, or breast cancers were analyzed (n = 1286). The cumulative incidence of objectively confirmed VTE was estimated with death as a competing risk and multivariate Fine and Gray regression.
RESULTS: Within 6 months, 120 VTE events (9.7%) occurred. The KRS and the new-Vienna CATS scores showed comparable c-stat. Stratification by KRS provided VTE cumulative incidences of 6.2%, 11.4%, and 11.5% in the low-, intermediate-, and high-risk categories, respectively (p = ns), and of 8.5% vs. 11.8% (p = ns) in the low- vs. high-risk group by the single 2-point cut-off value stratification. Using a pre-defined 60-point cut-off by the new-Vienna CATS score, 6.6% and 12.2% cumulative incidences were obtained in the low- and high-risk groups, respectively (p < 0.001). Furthermore, having a KRS ≥2 = or a new-Vienna CATS score >60 points was also an independent risk factor for mortality.
CONCLUSION: In our cohort, the 2 RAMs showed a comparable discriminating potential; however, after the application of cut-off values, the new-Vienna CATS score provided statistically significant stratification for VTE. Both RAMs proved to be effective in identifying patients at increased risk of mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Journal of thrombosis and haemostasis : JTH - 21(2023), 7 vom: 24. Juli, Seite 1869-1881 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Verzeroli, Cristina [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer |
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| Anmerkungen: |
Date Completed 19.06.2023 Date Revised 23.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jtha.2023.03.037 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Verzeroli, Cristina |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Utility of the Khorana and the new-Vienna CATS prediction scores in cancer patients of the HYPERCAN cohort |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 19.06.2023 | ||
| 500 | |a Date Revised 23.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Risk assessment models (RAMs) are relevant approaches to identify cancer outpatients at high risk of venous thromboembolism (VTE). Among the proposed RAMs, the Khorana (KRS) and the new-Vienna CATS risk scores have been externally validated in ambulatory patients with cancer | ||
| 520 | |a OBJECTIVES: To test KRS and new-Vienna CATS scores in 6-month VTE prediction and mortality in a large prospective cohort of metastatic cancer outpatients during chemotherapy | ||
| 520 | |a PATIENTS/METHODS: Newly diagnosed patients with metastatic non-small cell lung, colorectal, gastric, or breast cancers were analyzed (n = 1286). The cumulative incidence of objectively confirmed VTE was estimated with death as a competing risk and multivariate Fine and Gray regression | ||
| 520 | |a RESULTS: Within 6 months, 120 VTE events (9.7%) occurred. The KRS and the new-Vienna CATS scores showed comparable c-stat. Stratification by KRS provided VTE cumulative incidences of 6.2%, 11.4%, and 11.5% in the low-, intermediate-, and high-risk categories, respectively (p = ns), and of 8.5% vs. 11.8% (p = ns) in the low- vs. high-risk group by the single 2-point cut-off value stratification. Using a pre-defined 60-point cut-off by the new-Vienna CATS score, 6.6% and 12.2% cumulative incidences were obtained in the low- and high-risk groups, respectively (p < 0.001). Furthermore, having a KRS ≥2 = or a new-Vienna CATS score >60 points was also an independent risk factor for mortality | ||
| 520 | |a CONCLUSION: In our cohort, the 2 RAMs showed a comparable discriminating potential; however, after the application of cut-off values, the new-Vienna CATS score provided statistically significant stratification for VTE. Both RAMs proved to be effective in identifying patients at increased risk of mortality | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a metastatic | |
| 650 | 4 | |a risk assessment | |
| 650 | 4 | |a thromboembolism | |
| 650 | 4 | |a thrombosis | |
| 700 | 1 | |a Giaccherini, Cinzia |e verfasserin |4 aut | |
| 700 | 1 | |a Russo, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Bolognini, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Gamba, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Tartari, Carmen J |e verfasserin |4 aut | |
| 700 | 1 | |a Schieppati, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Ticozzi, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Vignoli, Alfonso |e verfasserin |4 aut | |
| 700 | 1 | |a Masci, Giovanna |e verfasserin |4 aut | |
| 700 | 1 | |a Sarmiento, Roberta |e verfasserin |4 aut | |
| 700 | 1 | |a Spinelli, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Malighetti, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Tondini, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Petrelli, Fausto |e verfasserin |4 aut | |
| 700 | 1 | |a Giuliani, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a D'Alessio, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Gasparini, Giampietro |e verfasserin |4 aut | |
| 700 | 1 | |a Minelli, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a De Braud, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Santoro, Armando |e verfasserin |4 aut | |
| 700 | 1 | |a Labianca, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Marchetti, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Falanga, Anna |e verfasserin |4 aut | |
| 700 | 0 | |a HYPERCAN Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Marina, Marchetti |e investigator |4 oth | |
| 700 | 1 | |a Silvia, Bolognini |e investigator |4 oth | |
| 700 | 1 | |a Sara, Gamba |e investigator |4 oth | |
| 700 | 1 | |a Cinzia, Giaccherini |e investigator |4 oth | |
| 700 | 1 | |a Laura, Russo |e investigator |4 oth | |
| 700 | 1 | |a Francesca, Schieppati |e investigator |4 oth | |
| 700 | 1 | |a Julia, Tartari Carmen |e investigator |4 oth | |
| 700 | 1 | |a Chiara, Ticozzi |e investigator |4 oth | |
| 700 | 1 | |a Cristina, Verzeroli |e investigator |4 oth | |
| 700 | 1 | |a Alfonso, Vignoli |e investigator |4 oth | |
| 700 | 1 | |a Armando, Santoro |e investigator |4 oth | |
| 700 | 1 | |a Giovanna, Masci |e investigator |4 oth | |
| 700 | 1 | |a Filippo, De Braud |e investigator |4 oth | |
| 700 | 1 | |a Antonia, Martinetti |e investigator |4 oth | |
| 700 | 1 | |a Carlo, Tondini |e investigator |4 oth | |
| 700 | 1 | |a Roberto, Labianca |e investigator |4 oth | |
| 700 | 1 | |a Giampietro, Gasparini |e investigator |4 oth | |
| 700 | 1 | |a Roberta, Sarmiento |e investigator |4 oth | |
| 700 | 1 | |a Elisabetta, Gennaro |e investigator |4 oth | |
| 700 | 1 | |a Mauro, Minelli |e investigator |4 oth | |
| 700 | 1 | |a Sandro, Barni |e investigator |4 oth | |
| 700 | 1 | |a Fausto, Petrelli |e investigator |4 oth | |
| 700 | 1 | |a Mara, Ghilardi |e investigator |4 oth | |
| 700 | 1 | |a Andrea, D'Alessio |e investigator |4 oth | |
| 700 | 1 | |a Sara, Cecchini |e investigator |4 oth | |
| 700 | 1 | |a Francesco, Giuliani |e investigator |4 oth | |
| 700 | 1 | |a Paolo, Malighetti |e investigator |4 oth | |
| 700 | 1 | |a Chiara, Morlotti |e investigator |4 oth | |
| 700 | 1 | |a Daniele, Spinelli |e investigator |4 oth | |
| 700 | 1 | |a Falanga, Anna |e investigator |4 oth | |
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