GIÁ TRỊ CỦA THANG ĐIỂM KHORANA TRONG DỰ BÁO HUYẾT KHỐI TĨNH MẠCH SÂU CHI DƯỚI Ở BỆNH NHÂN HÓA TRỊ LIỆU UNG THƯ

Abstract

Background: Lower extremity deep vein thrombosis (LEDVT) is a serious complication in cancer patients, increasing mortality and compromising treatment outcomes. The Khorana score, based on simple clinical factors, is recommended for risk stratification but its performance varies across populations, particularly in Asia. Currently, no data are available in Vietnam regarding the predictive value of the Khorana score in cancer patients undergoing chemotherapy. Objective: To evaluate the predictive value of the Khorana score for lower extremity deep vein thrombosis in Vietnamese cancer patients receiving first-line chemotherapy. Methods: We conducted a prospective cohort study including 198 newly diagnosed cancer patients aged ≥18 years who received at least four cycles of first-line chemotherapy at Ho Chi Minh City Oncology Hospital from August 2024 to September 2025. Patients were followed for 6 months after the first chemotherapy. Baseline demographic, clinical, and laboratory data were collected. Predictive performance of the score was assessed by using receiver operating characteristic (ROC) curves, sensitivity, specificity, and logistic regression analysis. Data analysis was performed using SPSS 20. Results: A total of 198 cancer patients receiving chemotherapy were included, with a median age of 56 years; 61.6% were female. The incidence of LEDVT was 5.1%. The KRS yielded an AUC of 0.714 (95% CI: 0.588–0.839), with sensitivity of 20% and specificity of 92.6% at the cutoff ≥3. Independent predictors of LEDVT included age ≥60 years (OR 8.03, 95% CI 1.41–45.53), use of topoisomerase inhibitors (OR 103.23, 95% CI 6.06–1756.56), and mitotic inhibitors (OR 14.23, 95% CI 1.68–120.39). Conclusion: The Khorana score showed fair predictive ability for LEDVT in Vietnamese cancer patients receiving first-line chemotherapy, with high specificity but limited sensitivity, useful for excluding low-risk patients. Age ≥60 and chemotherapy regimens containing topoisomerase or cell division inhibitors were independent predictors. Larger multicenter studies are needed to refine cutoff values and adapt prognostic models for Vietnam.