Abstract
Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.
Highlights
We have reviewed the risk factors for Venous thromboembolism (VTE) in ambulatory patients with lung cancer, discussed some main risk assessment models for VTE in this group of patients, and reflected upon advantages and disadvantages of the models
Anticoagulant thromboprophylaxis in ambulatory patients with lung cancer could be a life-saving treatment by preventing VTE
We have discussed some of the available risk prediction models for VTE which could be used in ambulatory patients with lung cancer
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Established a predictive model to assess individual risk of VTE in ambulatory cancer patients receiving chemotherapy [11] With this model, patients are assigned to one of three risk groups: low (score = 0), intermediate (score = 1–2) and high risk (score ≥ 3) [17]. The pooled data from 45 studies including various types of cancer showed that only 23.4% (95% CI: 18.4–29.4%) of the patients who developed VTE in the first six months had been classified as being at high risk according to the Khorana score [18]. We have explored literature gaps and provided suggestions for further research
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