Comparative analysis of risk prediction scores including all types of cancer-associated thrombosis

Classically, risk assessment models have focused on classic, clinically symptomatic thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE), not taking into account incidental thrombosis or non-conventional thrombotic events such as catheter-related thrombosis (CRT) or splenic vein thrombosis (SVT), although they contribute to morbidity and increase the consumption of health resources.

The primary objective was to evaluate and compare the predictive performance of the Khorana, PROTECHT, CONKO, modified VIENA-CATS (excluding P-selectin values), and MICA-CATS scores in assessing all type of thrombotic events in cancer patients (p) in the second cohort of the observational, multicenter, prospective ONCOTHROMB12-01 study. Data from 391 patients undergoing ambulatory systemic therapy across 11 Spanish hospitals between 2018 and 2021 were analyzed.

95 patients (24.3%) developed a thrombotic event. MICA-CATS score showed the best predictive capacity for all thrombotic events, as assessed by both the AUROC and the AUPRC, with an AUROC of 0.61 (95% CI 0.54-0.67) and an AUPRC of 0.38 (95% CI 0.30-0.46). For incidental thrombotic events, both the PROTECHT (0.62, 95% CI 0.55-0.68) and MICA-CATS (0.60, 95% CI 0.51-0.68) scores demonstrated utility.

Our findings demonstrate that MICA-CATS score has the best predictive capacity for overall venous thromboembolism (VTE) in cancer patients.