Table 2. Summary of clinical evidence highlighting the association between cancer and the risk of venous thromboembolism based on the Khorana score.
| Patient population | Patients ( N ) | Duration | Rate of VTE, % | ||
|---|---|---|---|---|---|
| Low risk (score = 0) | Medium risk (score = 1–2) | High risk (score ≥ 3) | |||
| Retrospective studies | |||||
| Solid tumours or malignant lymphoma 23 | 112 | 2 y | 5.0 | 15.9 | 41.4 |
| Any tumour type 24 | 932 | NA | 13.0 | 17.1 | 28.2 |
| Any advanced tumour type 25 | 1,415 | 2 mo | 1.5 | 4.8 | 12.9 |
| Any tumour type 26 | 378 | 113 d | 3.0 | 11.1 | |
| Any tumour type 27 | 150 | NA | 1.9 | 3.9 | 9.1 |
| Any tumour type 28 | 2,782 | 1 y | NA | Score >2: OR: 1.71 (95% CI: 1.16–2.59) |
OR: 2.54 (95% CI: 1.29–5.03) |
| Pancreatic tumours 29 | 108 | NA | NA | 14.0 | 27.0 |
| Disseminated germ cell tumours 30 | 254 | 11 y | NA | NA | OR: 11.8; p < 0.001 |
| Prospective studies | |||||
| Any tumour type 31 | 819 | 643 d | 1.5 (95% CI: 0.6–3.9) | Score = 1: 3.8 (95% CI: 1.9–7.4) Score = 2: 9.6 (95% CI: 6.2–14.7) |
17.7 (95% CI: 11.0–27.8) |
| Any tumour type 32 | 1,097 | 3 mo | NA | NA | OR: 3.5 (95% CI: 1–12.3) |
| Any tumour type 33 | 35 | 3 mo | NA | NA | 23.0 |
| Any tumour type 34 | 580 | 3 mo | 4.0 | NA | Score ≥ 2: 11.0 |
| Any tumour type 35 | 1,685 | 2 y | Score = 1: HR = 3.23 (95% CI: 1.53–6.81) p = 0.002; Score = 2: HR = 4.63 (95% CI: 2.20–9.75) p < 0.001 |
HR = 6.47 (95% CI: 2.99–14.00) p < 0.001 |
|
| Pooled analysis | |||||
| Non-Hodgkin's lymphoma 36 | 1,717 | NA | 2.2 (95% CI: NA) | 4.5 (95% CI: 2.3–6.7) | 6.6 (95% CI: 2.4–10.8) p = 0.012 |
Abbreviations: CI, confidence interval; HR, hazard ratio; NA, not applicable; OR, odds ratio; VTE, venous thromboembolism.
Source: Adapted from Angelini et al. 37