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Using the Khorana risk score to predict venous thromboembolism and overall survival in a cohort of Hispanic patients with solid malignancies

10 Nov 2022
Allan Ramos-Esquivel, Ana Marenco-Flores, Gabriel Hernández-Romero, Carlos Umaña-Mora, Ana Céspedes-Calvo, Raquel Mora-Hidalgo

Background: The Khorana risk score (KRS) for prognosis of venous thromboembolism (VTE) has been rarely explored in Hispanic populations.

Objective: To determine the value of the KRS for prediction of VTE and overall survival (OS) among Hispanic individuals with cancer.

Methods: We retrospectively evaluated all outpatients with newly diagnosed solid tumours receiving systemic chemotherapy in Hospital San Juan Dios, San José, Costa Rica, from January to December 2021. The 6-month cumulative VTE incidence according to the KRS categories was estimated using the Fine & Gray competing risk model. A Kaplan–Meier analysis was used to compare OS among KRS categories. The Cox regression analysis was performed to calculate the hazard ratio (HR) and its corresponding 95% confidence interval (CI). The receiver operating characteristic (ROC) analysis was performed to identify the optimal cutoff value to predict VTE during follow-up.

Results: A total of 708 patients were included in the analysis. After a median follow-up of 8.13 months, the cumulative incidence of VTE at 6 months was 1.56% (95% CI: 0.83%–6.82%), 4.83% (95% CI: 2.81%–7.66%) and 8.84% (95% CI: 4.30%–15.42%) for low-, intermediate- and high-risk Khorana score categories, respectively (Gray’s p value: 0.0178). The optimal cutoff for the KRS to predict VTE was 2 (area under the ROC curve: 0.65; 95% CI: 0.55–0.756). The KRS was independently associated with overall mortality (HR: 1.83; 95% CI: 1.46–2.29; p < 0.001, for the comparison of ‘high-risk’ and ‘low-risk’ KRS).

Conclusions: The KRS is a valid tool to predict VTE and mortality in a cohort of Hispanic outpatients with newly diagnosed solid tumours.

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