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CC BY 4.0 · TH Open 2024; 08(01): e9-e18
DOI: 10.1055/a-2207-7715
Original Article

A Predictive Model for Cancer-Associated Thrombosis in Japanese Cancer Patients: Findings from the J-Khorana Registry

Masaaki Shoji
1   Department of General Internal Medicine, National Cancer Center Hospital, Tokyo, Japan
,
Yugo Yamashita
2   Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Masanobu Ishii
3   Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
,
Hitoki Inoue
4   Department of Cardiology, National Hospital Organization (NHO) Hokkaido Cancer Center, Hokkaido, Japan
,
Hiroshi Kato
5   Division of Onco-Cardiology, Miyagi Cancer Center, Miyagi, Japan
,
Shin Fujita
6   Department of Surgery, Tochigi Cancer Center, Tochigi, Japan
,
Kazuhiro Matsui
7   Department of Internal Medicine, Onco-Cardiology Unit, Saitama Cancer Center, Saitama, Japan
,
Kazuko Tajiri
8   Department of Cardiology, National Cancer Center Hospital East, Chiba, Japan
,
Mizuo Nameki
9   Division of Cardiology, Chiba Cancer Center, Chiba, Japan
,
Nao Muraoka
10   Division of Cardiology, Shizuoka Cancer Center, Shizuoka, Japan.
,
Akiko Nonaka
11   Division of Onco-Cardiology, Hyogo Cancer Center, Hyogo, Japan
,
Hiroshi Sugino
12   Division of Cardiology, NHO Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
,
Mihoko Kono
13   Department of Onco-Cardiology, NHO Kyushu Cancer Center, Fukuoka, Japan
,
Toru Oka
7   Department of Internal Medicine, Onco-Cardiology Unit, Saitama Cancer Center, Saitama, Japan
,
Daisuke Sueta 
3   Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
,
Issei Komuro
14   Department of Frontier Cardiovascular Science, International University of Health and Welfare, Tokyo, Japan
15   Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
,
Kenichi Tsujita
3   Department of Cardiovascular Medicine, Kumamoto University School of Medicine, Kumamoto, Japan
,
on behalf of J-Khorana Registry Investigators › Author Affiliations Funding This study was supported in part by Grants-in-Aid for Scientific Research (#20K17087) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
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Abstract

Background Although the close relationship between cancer and venous thromboembolism (VTE) has been identified, risk stratification for VTE in Japanese patients with cancer remains unclear.

Objectives This study aimed to validate the Khorana VTE risk assessment score (KRS) for VTE diagnosis and establish an optimal predictive model for VTE in Japanese patients with cancer.

Methods A total of 7,955 Japanese patients with cancer were subdivided into low- (0), intermediate- (1–2), and high-score (3) groups according to the KRS. Using 37 explanatory variables, a total of 2,833 patients with cancer were divided into derivation and validation cohorts (5:5). A risk model for Japanese participants was developed using the derivation cohort data.

Results The prevalence of VTE in low-, intermediate-, and high-score patients was 1.2, 2.5, and 4.3%, respectively. Logistic regression analysis demonstrated that cancer stage (III–IV) and KRS ≥ 2 were independent and significant predictors of VTE onset. The risk model for VTE assigned 1 point to body mass index ≥25 kg/m2 and 2 points each to the prevalence of osteochondral cancer and D-dimer level ≥1.47 µg/mL. The areas under the curve of the risk model were 0.763 and 0.656 in the derivation and validation cohorts, respectively.

Conclusion The KRS was useful in Japanese patients, and our new predictive model may be helpful for the diagnosis of VTE in Japanese patients with cancer.

Keywords

venous thromboembolism - cancer - predictive model

X (formerly Twitter)

The Khorana VTE risk assessment score was useful in Japanese patients, and our new predictive model, using BMI, cancer site, and D-dimer level, may aid the diagnosis of VTE in Japanese patients with cancer. #VTE#VenousThromboembolism#Cancer-AssociatedThrombosis


X (formerly Twitter): @daisukesueta


Trial Registration Number

The University Hospital Medical Information Network Clinical Trials Registry (UMIN000050391).


Supplementary Material



Publication History

Received: 05 October 2023

Accepted: 07 November 2023

Accepted Manuscript online:
09 November 2023

Article published online:
08 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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