The overall risk of VTE in the setting of malignancy is 4-8%, and up to 20% in high risk cancer populations (gastric, pancreatic and lung).1 Thrombosis is a common cause of death in cancer patients2 and potentially can be reduced with prophylactic anticoagulation, but side effects such as risk of bleeding, and cost need to be considered. It is important to risk-stratify patients to identify high-risk groups who are likely to get the most benefit with least harm.3
Retrospective audit of oncology patients at Goulburn Valley Health who received chemotherapy between June 2014 and July 2016 and were diagnosed with VTE (deep venous thrombosis and/or pulmonary embolism). Patients were identified using oncology and pharmacy databases. Electronic and hardcopy of clinical records of eligible patients were assessed for demographic and clinical variables needed to apply the Khorana predictive risk model for chemotherapy-associated VTE.
In the studied 26-month period 58 patients were diagnosed with VTE. Median age was 70 years old (35–90 years old), and 32 patients (55%) were male. Cancer types most commonly associated to VTE were colorectal (26 patients, 45%), breast (9 patients, 15%) and lung (9 patients, 15%). 51 patients (88%) were ECOG 0 or 1. Pulmonary embolism was diagnosed in 25 patients (43%) and high Khorana score (3 or 4) was only identified in 3 patients (5%).
Frequency of VTE in patients receiving chemotherapy in the regional setting is in keeping with international literature. Types of cancer associated with VTE were colorectal, breast and lung, however this is most likely related its frequent presentation rather than biology. There was no association of high Khorana scores (3-4) with risk of VTE.