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- Title
A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients.
- Authors
Gomez-Rosas, Patricia; Giaccherini, Cinzia; Russo, Laura; Verzeroli, Cristina; Gamba, Sara; Tartari, Carmen Julia; Bolognini, Silvia; Ticozzi, Chiara; Schieppati, Francesca; Barcella, Luca; Sarmiento, Roberta; Masci, Giovanna; Tondini, Carlo; Petrelli, Fausto; Giuliani, Francesco; D'Alessio, Andrea; Minelli, Mauro; De Braud, Filippo; Santoro, Armando; Labianca, Roberto
- Abstract
Simple Summary: The predictive value of existing venous thromboembolism risk assessment models (RAMs) in lung cancer patients is still debated, and the design of new models represents an unmet clinical need. In a prospective cohort of patients with newly diagnosed metastatic lung cancer, clinical characteristics, and hemostatic biomarkers assessed before initiating chemotherapy were used to generate a more accurate RAM. This easy-to-implement RAM was compared to four previously published scores, which were also externally validated in this study. (1) Background: Venous thromboembolism (VTE) is a frequent complication in ambulatory lung cancer patients during chemotherapy and is associated with increased mortality. (2) Methods: We analyzed 568 newly diagnosed metastatic lung cancer patients prospectively enrolled in the HYPERCAN study. Blood samples collected before chemotherapy were tested for thrombin generation (TG) and a panel of hemostatic biomarkers. The Khorana risk score (KRS), new-Vienna CATS, PROTECHT, and CONKO risk assessment models (RAMs) were applied. (3) Results: Within 6 months, the cumulative incidences of VTE and mortality were 12% and 29%, respectively. Patients with VTE showed significantly increased levels of D-dimer, FVIII, prothrombin fragment 1 + 2, and TG. D-dimer and ECOG performance status were identified as independent risk factors for VTE and mortality by multivariable analysis and utilized to generate a risk score that provided a cumulative incidence of VTE of 6% vs. 25%, death of 19% vs. 55%, and in the low- vs. high-risk group, respectively (p < 0.001). While all published RAMs significantly stratified patients for risk of death, only the CATS and CONKO were able to stratify patients for VTE. (4) Conclusions: A new prediction model was generated to stratify lung cancer patients for VTE and mortality risk, where other published RAMs failed.
- Subjects
MORTALITY risk factors; CANCER patient psychology; VEINS; OUTPATIENT medical care; CANCER chemotherapy; MULTIVARIATE analysis; LUNG tumors; THROMBOEMBOLISM; RESEARCH funding; PREDICTION models
- Publication
Cancers, 2023, Vol 15, Issue 18, p4588
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers15184588