Prevalence of Venous Thromboembolism in Cholangiocarcinoma Patients Receiving Chemotherapy and Validation of Khorana Score
Panupong Sangsri1, Aumkhae Sookprasert1, Kosin Wirasorn1, Jarin Chindaprasirt1, Piyakarn Watcharenwong1, Thanachai Sanlung1
Affiliation : 1 Medical Oncology Unit, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: Khorana score (KS) have used to evaluate the risk of chemotherapy-associated venous thromboembolism (VTE) and provide thromboprophylaxis for high-risk patients. However, the applicability of the score to cholangiocarcinoma (CCA) patients remains unclear due to the limited inclusion of patients with CCA in the score derivation process.
Objective: The primary objective focused on the prevalence of VTE within 180 days and the KS score was externally validated in this particular cohort.
Materials and Methods: This retrospective cohort study was conducted at a tertiary care hospital in Northeastern Thailand between January 2014 and December 2021. The study collected baseline clinical characteristics and laboratory data of patients with CCA undergoing palliative chemotherapy and follow-up data to assess the endpoints.
Results: Among the 402 patients included in the cohort, 48 (11.9%) experienced VTE within 180 days. Consequently, the decision was made to assign 1 point for a primary site of cancer factor in the KS calculation. The KS was found to be significantly associated with VTE incidents, with an odds ratio (OR) of 1.63 (95% CI 1.16, 2.29, p=0.005) and an AUC of 0.616 (95% CI 0.534, 0.698). The presence of VTE and higher KS scores were both associated with a worse prognosis.
Conclusion: CCA should be considered a high-risk tumor type for chemotherapy-associated VTE. The KS has been validated as useful in predicting VTE in this particular tumor type. Additionally, VTE or higher KS were associated with shorter overall survival.
Received 6 February 2024 | Revised 30 May 2024 | Accepted 11 June 2024
DOI: 10.35755/jmedassocthai.2024.S01.S79-S85
Keywords : Cholangiocarcinoma; Chemotherapy; Venous thromboembolism; Khorana score; External validation; Survival
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