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

• Published in: Clinical and applied thrombosis/hemostasis Vol. 24; no. 8; pp. 1347 - 1351
• Main Authors: Vathiotis, Ioannis, Dimakakos, Evangelos P., Boura, Paraskevi, Ntineri, Angeliki, Charpidou, Andiani, Gerotziafas, Grigoris, Syrigos, Konstantinos
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2018; SAGE PUBLICATIONS, INC
• Subjects: Adenocarcinoma of Lung - drug therapy; Adenocarcinoma of Lung - mortality; Aged; Cancer; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Chemotherapy; Chemotherapy, Adjuvant - adverse effects; Chemotherapy, Adjuvant - methods; Disease-Free Survival; Female; Health risk assessment; Humans; Life Sciences; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Male; Middle Aged; Original; Risk Factors; Survival Rate; Thromboembolism; Venous Thromboembolism - chemically induced; Venous Thromboembolism - mortality; Khorana score; lung cancer; chemotherapy; venous thromboembolism
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029618777153

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.