Khorana Score: Νew Predictor of Early Mortality in Patients With Lung Adenocarcinoma

Abstract

Venous thromboembolism (VTE) is a typical complication in patients with lung cancer. Khorana score is an established tool for thromboembolic risk stratification of ambulatory patients with cancer undergoing outpatient chemotherapy. The aim of this study was to evaluate the predictive value of the Khorana score for VTE and death in patients with lung adenocarcinoma during first-line or adjuvant chemotherapy. Medical records of 130 patients with lung adenocarcinoma receiving first-line or adjuvant chemotherapy were retrospectively studied during the time period June 2013 to May 2015. Venous thromboembolism occurred in 13 (10.0%) patients. Thromboembolic events were significantly correlated with reduced survival during treatment period (hazard ratio [HR]: 3.24; 95% confidence interval [CI]: 1.11-9.49; P = .032). The VTE rates did not present statistically significant difference between different Khorana score groups ( P = .96). In univariate analysis, the risk of death during treatment period (median: 16 weeks) was 3.75 times higher in high-risk versus intermediate-risk patients (HR: 3.75, 95% CI: 1.36-10.36; P = .001) and had 2.25 times higher per point increase in the Khorana score (HR: 2.25, 95% CI: 1.36-3.73; P = .002); the above results were also reproduced in multivariate analysis. Khorana score represents a valuable tool for identifying patients with cancer in low thromboembolic risk but does not preserve its predictive value for higher risk individuals. Khorana score is an independent risk factor for death in patients with lung adenocarcinoma receiving first-line or adjuvant chemotherapy.

Response to the letter to the editor: “New data for venous thromboembolism in patients with small cell lung cancer: A review”

“…As for Khorana score, the new data support that it is not a valuable and predictive score for VTE events in cancer patients and in different type of cancers. [3][4][5][6] The combination of Khorana score with other prediction tools (older or more recent) might improve the efficacy of VTE prevention.…”

Tinzaparin Safety in Patients With Cancer and Renal Impairment: A Systematic Review

“…Patients with cancer share numerous patient-, disease-and treatment-related risk factors that considerably increase the risk for primary and recurrent VTE as well as bleeding complications from anticoagulation therapy. [2][3][4][5] Likewise, patients with renal impairment are at increased risk for bleeding due to frequent invasive treatment procedures, coexisting platelet dysfunction and potential bioaccumulation of anticoagulants. 6 Low-molecular-weight heparins (LMWHs), derived from the degradation of porcine unfractionated heparin, are the most thoroughly studied drugs for primary and secondary VTE prevention.…”

Identification of critical genes and pathways related to venous thromboembolism in non-small cell lung cancer patients using integrated bioinformatics analysis

“…Non-small cell lung cancer (NSCLC) patients account for 80-85% of lung cancer cases [6]. Relative risk of developing VTE in NSCLC patients is almost 2 times as high as that in those with small-cell lung cancer (SCLC) [7]. Notably, 7.3-13.6% of patients with NSCLC are related to VTE [8,9].…”