Key result
High-risk Khorana scores predict a low ~4% 6-month CAT rate in East Asian chemotherapy patients.
Why the study?
The Khorana score has not been well studied in East Asian cancer patients, who have different genetic backgrounds for inherited thrombophilia, body metabolism, and cancer epidemiology.
Does the Khorana score accurately predict cancer-associated thrombosis in East Asian patients undergoing ambulatory chemotherapy?
Cohort (n=11,714)
No
Does the Khorana score accurately predict cancer-associated thrombosis in East Asian patients undergoing ambulatory chemotherapy?
The Khorana score partially predicts cancer-associated thrombosis in East Asian patients, but its performance may be improved by modifying the BMI cutoff to 25 kg/m² and including age ≥65 years.
Answers are grounded in this paper and cite their sources.
Supports cautious Khorana use in East Asian patients; leaves open validation of BMI and age modifications.
BACKGROUND: The Khorana score (KS) has not been well studied in East Asian cancer patients, who have different genetic backgrounds for inherited thrombophilia, body metabolism, and cancer epidemiology. METHODS: By using the Common Data Model, we retrospectively collected deidentified data from 11,714 consecutive newly diagnosed cancer patients who underwent first-line chemotherapy from December 2015 to December 2021 at a single institution in Korea, and we applied the KS for cancer-associated thrombosis (CAT) prediction. Age at diagnosis, sex, and use of highly thrombogenic chemotherapeutics were additionally investigated as potential risk factors for CAT development. RESULTS: improved the prediction of CAT. Age ≥ 65 years and the use of highly thrombogenic chemotherapeutics were independently associated with CAT development. KS values of 1 ~ 2 and ≥ 3 accounted for 52.3% and 7.6% of all patients, respectively, and the incidence of CAT in these groups was 2.16% and 4.16%, respectively, suggesting a lower incidence of CAT in the study population than in Westerners. The KS component regarding the site of cancer showed a good association with CAT development but needed some improvement. CONCLUSION: The KS was partially validated to predict CAT in Korean cancer patients undergoing modern chemotherapy. Modifying the BMI cutoff, adding other risk variables, and refining the use of cancer-site data for CAT risk prediction may improve the performance of the KS for CAT prediction in East Asian patients.
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Ha et al. (2023) conducted a cohort in Cancer-associated thrombosis (n=11,714). Khorana score ≥ 3 (high risk) vs. Khorana score 0 (low risk) was evaluated on 6-month incidence of cancer-associated thrombosis. In East Asian cancer patients undergoing ambulatory chemotherapy, the 6-month incidence of cancer-associated thrombosis was 4.16% in the high-risk Khorana score group and 1.77% overall, suggesting a lower incidence than in Western populations.
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