@article{ff0452a418514287bf17cbacecbd27c6,
title = "Khorana score and thromboembolic risk in stage II–III colorectal cancer patients: a post hoc analysis from the adjuvant TOSCA trial: Therapeutic Advances in Medical Oncology",
abstract = "Background: The risk of venous thromboembolic events (VTE) during adjuvant chemotherapy for colorectal cancer (CRC) is unknown. We aim to evaluate if the Khorana score (KS) can predict this risk, and if it represents a prognostic factor for overall survival (OS) through a post hoc analysis of the phase III TOSCA trial of different durations (3- versus 6-months) of adjuvant chemotherapy. Methods: A logistic regression model was used to test the associations between the risk of VTE and the KS. The results are expressed as odds ratios (OR) with 95% confidence intervals (95% CI). To assess the effect of the KS on OS, multivariable analyses using Cox regression models were performed. The results are expressed as hazard ratios (HR) with 95% CI. Results: Among 1380 CRC patients with available data, the VTE risk (n = 72 events: 5.2%) was similar in the two duration arms (5.5% versus 4.9%), with 0.2% of patients belonging to the high-risk KS group. Rates of VTE were similar in the low- and intermediate-risk groups (4.8% versus 6.4%). KS did not represent an independent predictive factor for VTE occurrence. Chemotherapy duration was not associated with VTE risk. In addition, KS was not prognostic for OS in multivariate analysis (HR: 0.92, 95% CI, 0.63–1.36; p = 0.6835). Conclusions: The use of the KS did not predict VTEs in a low–moderate thromboembolic risk population as CRC. These data did not support the use of KS to predict VTE during adjuvant chemotherapy, and suggest that other risk assessment models should be researched. {\textcopyright} The Author(s), 2020.",
keywords = "adjuvant chemotherapy, colorectal cancer, Khorana score, thrombosis, adult, aged, Article, cancer staging, controlled study, female, follow up, high risk population, human, intermediate risk population, leukocyte count, low risk population, major clinical study, male, middle aged, multicenter study, open study, overall survival, phase 3 clinical trial, platelet count, prediction, predictive value, priority journal, randomized controlled trial, recurrence free survival, risk assessment, scoring system, sensitivity and specificity, thromboembolism, tumor localization, venous thromboembolism, very elderly",
author = "S. Barni and G. Rosati and S. Lonardi and N. Pella and M. Banzi and M.G. Zampino and K.F. Dotti and L. Rimassa and P. Marchetti and E. Maiello and F. Artioli and D. Ferrari and R. Labianca and P. Bidoli and A. Zaniboni and A. Sobrero and V. Iaffaioli and {De Placido}, S. and G.L. Frassineti and A. Ciarlo and A. Buonadonna and N. Silvestris and E. Piazza and L. Pavesi and M. Moroni and M. Clerico and M. Aglietta and P. Giordani and F. Galli and F. Petrelli",
note = "Export Date: 18 February 2021 Correspondence Address: Petrelli, F.; Oncology Unit, Piazzale Ospedale 1, Italy; email: faupe@libero.it Funding text 1: GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell?Apparato Digerente - Ufficio Operativo): L. Frontini, S. Rota, L. Cozzi. The author(s) received no financial support for the research, authorship, and publication of this article. References: Timp, J.F., Braekkan, S.K., Versteeg, H.H., Epidemiology of cancer-associated venous thrombosis (2013) Blood, 122, pp. 1712-1723; Khorana, A.A., Kuderer, N.M., Culakova, E., Development and validation of a predictive model for chemotherapy-associated thrombosis (2008) Blood, 111, pp. 4902-4907; Metcalf, R.L., Al-Hadithi, E., Hopley, N., Characterisation and risk assessment of venous thromboembolism in gastrointestinal cancers (2017) World J Gastrointest Oncol, 9, p. 363; Mandal{\'a}, M., Barni, S., Prins, M., Acquired and inherited risk factors for developing venous thromboembolism in cancer patients receiving adjuvant chemotherapy: a prospective trial (2009) Ann Oncol, 21, pp. 871-876; Sobrero, A., Lonardi, S., Rosati, G., FOLFOX or CAPOX in stage II to III colon cancer: efficacy results of the italian three or six colon adjuvant trial (2018) J Clin Oncol, 36, pp. 1478-1485; Lonardi, S., Sobrero, A., Rosati, G., Phase III trial comparing 3–6 months of adjuvant FOLFOX4/XELOX in stage II-III colon cancer: safety and compliance in the TOSCA trial (2016) Ann Oncol, 27, pp. 2074-2081; Auer, R.A.C., Scheer, A.S., McSparron, J.I., Postoperative venous thromboembolism predicts survival in cancer patients (2012) Ann Surg, 255, pp. 963-970; Khorana, A.A., Francis, C.W., Culakova, E., Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study (2005) Cancer, 104, pp. 2822-2829; Hanna, N., Bikov, K., McNally, D., Impact of venous thromboembolism on mortality of elderly medicare patients with stage III colon cancer (2012) Oncologist, 17, pp. 1191-1197; Nalluri, S.R., Chu, D., Keresztes, R., Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis (2008) JAMA, 300, pp. 2277-2285; Seng, S., Liu, Z., Chiu, S.K., Risk of venous thromboembolism in patients with cancer treated with Cisplatin: a systematic review and meta-analysis (2012) J Clin Oncol, 30, pp. 4416-4426; Lyman, G.H., Eckert, L., Wang, Y., Venous thromboembolism risk in patients with cancer receiving chemotherapy: a real-world analysis (2013) Oncologist, 18, pp. 1321-1329; Tafur, A.J., Caprini, J.A., Cote, L., Predictors of active cancer thromboembolic outcomes: RIETE experience of the Khorana score in cancer-associated thrombosis (2017) Thromb Haemost, 117, pp. 1192-1198; Kuderer, N.M., Culakova, E., Lyman, G.H., A validated risk score for venous thromboembolism is predictive of cancer progression and mortality (2016) Oncologist, 21, pp. 861-867; Agnelli, G., George, D.J., Kakkar, A.K., Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer (2012) N Engl J Med, 366, pp. 601-609; Mulder, F.I., Candeloro, M., Kamphuisen, P.W., The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis (2019) Haematologica, 104, pp. 1277-1287; Di Nisio, M., Porreca, E., Ferrante, N., Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy (2012) Cochrane Database Syst Rev, 2. , CD008500; Riedl, J.M., Posch, F., Bezan, A., Patterns of venous thromboembolism risk in patients with localized colorectal cancer undergoing adjuvant chemotherapy or active surveillance: an observational cohort study (2017) BMC Cancer, 17, p. 415; Gerotziafas, G.T., Taher, A., Abdel-Razeq, H., A predictive score for thrombosis associated with breast, colorectal, lung, or ovarian cancer: the prospective COMPASS–cancer-associated thrombosis study (2017) Oncologist, 22, pp. 1222-1231",
year = "2020",
doi = "10.1177/1758835919899850",
language = "English",
volume = "12",
journal = "Ther. Adv. Med. Oncol.",
issn = "1758-8340",
publisher = "SAGE Publications Inc.",
}