Cargando…
Khorana score and thromboembolic risk in stage II–III colorectal cancer patients: a post hoc analysis from the adjuvant TOSCA trial
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 ph...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974756/ https://www.ncbi.nlm.nih.gov/pubmed/32010236 http://dx.doi.org/10.1177/1758835919899850 |
_version_ | 1783490161264295936 |
---|---|
author | Barni, Sandro Rosati, Gerardo Lonardi, Sara Pella, Nicoletta Banzi, Maria Zampino, Maria G. Dotti, Katia F. Rimassa, Lorenza Marchetti, Paolo Maiello, Evaristo Artioli, Fabrizio Ferrari, Daris Labianca, Roberto Bidoli, Paolo Zaniboni, Alberto Sobrero, Alberto Iaffaioli, Vincenzo De Placido, Sabino Frassineti, Gian Luca Ciarlo, Andrea Buonadonna, Angela Silvestris, Nicola Piazza, Elena Pavesi, Lorenzo Moroni, Mauro Clerico, Mario Aglietta, Massimo Giordani, Paolo Galli, Francesca Galli, Fabio Petrelli, Fausto |
author_facet | Barni, Sandro Rosati, Gerardo Lonardi, Sara Pella, Nicoletta Banzi, Maria Zampino, Maria G. Dotti, Katia F. Rimassa, Lorenza Marchetti, Paolo Maiello, Evaristo Artioli, Fabrizio Ferrari, Daris Labianca, Roberto Bidoli, Paolo Zaniboni, Alberto Sobrero, Alberto Iaffaioli, Vincenzo De Placido, Sabino Frassineti, Gian Luca Ciarlo, Andrea Buonadonna, Angela Silvestris, Nicola Piazza, Elena Pavesi, Lorenzo Moroni, Mauro Clerico, Mario Aglietta, Massimo Giordani, Paolo Galli, Francesca Galli, Fabio Petrelli, Fausto |
author_sort | Barni, Sandro |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6974756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-69747562020-01-31 Khorana score and thromboembolic risk in stage II–III colorectal cancer patients: a post hoc analysis from the adjuvant TOSCA trial Barni, Sandro Rosati, Gerardo Lonardi, Sara Pella, Nicoletta Banzi, Maria Zampino, Maria G. Dotti, Katia F. Rimassa, Lorenza Marchetti, Paolo Maiello, Evaristo Artioli, Fabrizio Ferrari, Daris Labianca, Roberto Bidoli, Paolo Zaniboni, Alberto Sobrero, Alberto Iaffaioli, Vincenzo De Placido, Sabino Frassineti, Gian Luca Ciarlo, Andrea Buonadonna, Angela Silvestris, Nicola Piazza, Elena Pavesi, Lorenzo Moroni, Mauro Clerico, Mario Aglietta, Massimo Giordani, Paolo Galli, Francesca Galli, Fabio Petrelli, Fausto Ther Adv Med Oncol Original Research 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. SAGE Publications 2020-01-20 /pmc/articles/PMC6974756/ /pubmed/32010236 http://dx.doi.org/10.1177/1758835919899850 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Barni, Sandro Rosati, Gerardo Lonardi, Sara Pella, Nicoletta Banzi, Maria Zampino, Maria G. Dotti, Katia F. Rimassa, Lorenza Marchetti, Paolo Maiello, Evaristo Artioli, Fabrizio Ferrari, Daris Labianca, Roberto Bidoli, Paolo Zaniboni, Alberto Sobrero, Alberto Iaffaioli, Vincenzo De Placido, Sabino Frassineti, Gian Luca Ciarlo, Andrea Buonadonna, Angela Silvestris, Nicola Piazza, Elena Pavesi, Lorenzo Moroni, Mauro Clerico, Mario Aglietta, Massimo Giordani, Paolo Galli, Francesca Galli, Fabio Petrelli, Fausto Khorana score and thromboembolic risk in stage II–III colorectal cancer patients: a post hoc analysis from the adjuvant TOSCA trial |
title | Khorana score and thromboembolic risk in stage II–III colorectal
cancer patients: a post hoc analysis from the adjuvant TOSCA
trial |
title_full | Khorana score and thromboembolic risk in stage II–III colorectal
cancer patients: a post hoc analysis from the adjuvant TOSCA
trial |
title_fullStr | Khorana score and thromboembolic risk in stage II–III colorectal
cancer patients: a post hoc analysis from the adjuvant TOSCA
trial |
title_full_unstemmed | Khorana score and thromboembolic risk in stage II–III colorectal
cancer patients: a post hoc analysis from the adjuvant TOSCA
trial |
title_short | Khorana score and thromboembolic risk in stage II–III colorectal
cancer patients: a post hoc analysis from the adjuvant TOSCA
trial |
title_sort | khorana score and thromboembolic risk in stage ii–iii colorectal
cancer patients: a post hoc analysis from the adjuvant tosca
trial |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974756/ https://www.ncbi.nlm.nih.gov/pubmed/32010236 http://dx.doi.org/10.1177/1758835919899850 |
work_keys_str_mv | AT barnisandro khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT rosatigerardo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT lonardisara khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT pellanicoletta khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT banzimaria khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT zampinomariag khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT dottikatiaf khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT rimassalorenza khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT marchettipaolo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT maielloevaristo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT artiolifabrizio khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT ferraridaris khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT labiancaroberto khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT bidolipaolo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT zanibonialberto khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT sobreroalberto khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT iaffaiolivincenzo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT deplacidosabino khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT frassinetigianluca khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT ciarloandrea khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT buonadonnaangela khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT silvestrisnicola khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT piazzaelena khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT pavesilorenzo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT moronimauro khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT clericomario khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT agliettamassimo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT giordanipaolo khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT gallifrancesca khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT gallifabio khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial AT petrellifausto khoranascoreandthromboembolicriskinstageiiiiicolorectalcancerpatientsaposthocanalysisfromtheadjuvanttoscatrial |