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. 2025 Oct 26.
doi: 10.1007/s12094-025-04099-2. Online ahead of print.

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

Irene González Caraballo  1 , Bárbara Lobato Delgado  2 , Magdalena Ruiz Zamorano  3 , Mercedes Salgado  4 , Vanessa Pachón  5 , Joaquina Martínez Galán  6 , Victoria Castellón  7 , Itziar Gardeazabal  8 , Ana Ferrer  9 , Jaime Rubio Pérez  10 , Ignacio García Escobar  11 , Isaura Fernández  12 , Teresa Quintanar  13 , Carme Font  14 , Javier Soto Alsar  15 , Laura Ortega Morán  15 , José Manuel Soria Fernández  16 , Andrés J Muñoz Martín  15
Affiliations

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

Irene González Caraballo et al. Clin Transl Oncol. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

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

Keywords: Cancer-associated thrombosis; D-dimer; Incidental events; Risk assessment model; Venous thromboembolism.

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Conflict of interest statement

Declarations. Conflict of interest: Irene González Caraballo: Travel, accommodations, expenses: MSD, Rovi, Gilead, Rizmoic. Andrés Jesús Muñoz Martín: consultant or advisory role: GSK, Pfizer, BMS-Celgene, Sanofi, Astra-Zeneca, MSD, Lilly, Servier, Roche, Taiho, Leo Pharma, Regeneron. Research funding: Leo Pharma, Sanofi, BMS-Celgene. Speakers’ bureau: Rovi, Menarini, Stada, Medscape. Patents, royalties, other intellectual property: risk assessment model in venous thromboembolism in cancer patients. Liquid biopsy developed with laser technology. The rest of the authors declare no conflicts of interest for the present article.

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