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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...

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Autores principales: 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
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
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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.
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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
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