Trujillo-Santos Javier, García-Escobar Ignacio, Salgado Mercedes, Araújo António, Martínez-de-Castro Eva, Molina Raquel, Castellón-Rubio Victoria E, Domènech Pere, Gallardo Enrique, Colomé Esteve, Torres Ferran, Benítez-Montañez José-Carlos, Porta Rut, Lobo-de-Mena Míriam, Malheiro Mariana, Font Carme, Brozos-Vázquez Elena, Garicano Fernando, Sapena Víctor, Costa Ana-Lucia, Albuquerque Ana-Cristina, Cerezuela Pablo
Internal Medicine Department, Santa Lucía General University Hospital, Catholic University of Murcia, 30202 Murcia, Spain.
Medical Oncology Department, General University Hospital of Toledo, 45007 Toledo, Spain.
Oncologist. 2025 Aug 4;30(8). doi: 10.1093/oncolo/oyae334.
Venous thromboembolism (VTE) is one of the leading causes of death in patients with cancer. Currently, there is a need to develop an easily applicable risk model that can identify patients who will benefit from receiving primary thromboprophylaxis to reduce the incidence of VTE.
This was a non-interventional, multicenter, observational, prospective study carried out in 62 Oncology and Hematology services in Spain and Portugal between January 2018 and December 2019. The main objective of the CARTAGO study was to develop a predictive model within a competitive risk framework to assess the risk of VTE in patients with cancer undergoing chemotherapy, biological, or hormonal treatment.
A total of 1596 patients were analyzed. VTE events occurred in 124 (8%) during the 6-month follow-up period (42% of deep vein thrombosis [DVT], 48% of pulmonary embolism [PE], and 10% of both DVT and PE). Four variables were selected for the multivariate predictive model to determine the risk of VTE (tumor type, D-dimer, compression of a vessel by the tumor, and leukocyte count). The 4 variables were associated with an increased risk of VTE (C-statistic, 0.646 [95%CI, 0.620-0.673]). The most significant variables in the internal validation with bootstrapping were the "very high risk" tumors (hazard ratio [HR] 2.032; 95%CI, 1.287-3.211).
The CARTAGO model predicts the VTE risk in patients with cancer receiving anticancer therapy in an outpatient setting. This model can easily aid in identifying ambulatory patients who would probably benefit from primary thromboprophylaxis.
静脉血栓栓塞症（VTE）是癌症患者主要的死亡原因之一。目前，需要开发一种易于应用的风险模型，以识别那些将从接受一级血栓预防中获益的患者，从而降低VTE的发生率。
这是一项非干预性、多中心、观察性前瞻性研究，于2018年1月至2019年12月在西班牙和葡萄牙的62个肿瘤学和血液学服务机构开展。CARTAGO研究的主要目标是在竞争风险框架内开发一种预测模型，以评估接受化疗、生物治疗或激素治疗的癌症患者发生VTE的风险。
共分析了1596例患者。在6个月的随访期内，124例（8%）发生了VTE事件（42%为深静脉血栓形成[DVT]，48%为肺栓塞[PE]，10%为DVT和PE两者皆有）。多变量预测模型选择了4个变量来确定VTE风险（肿瘤类型、D-二聚体、肿瘤对血管的压迫以及白细胞计数）。这4个变量与VTE风险增加相关（C统计量，0.646[95%CI，0.620-0.673]）。在自展法内部验证中最显著的变量是“极高风险”肿瘤（风险比[HR]2.032；95%CI，1.287-3.211）。
CARTAGO模型可预测门诊接受抗癌治疗的癌症患者的VTE风险。该模型可轻松帮助识别可能从一级血栓预防中获益的门诊患者。
