Characterization of thrombosis risk in ambulatory patients with cancer: results of the observational, prospective, multicenter CARTAGO study
Authors: 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 ,   the CARTAGO Study Group, Agraso Sara , Anguera Georgia , Antonio Maite , Arias David , Biosca Mercedes , Blasco Ana , Bustins Anna , Cacho Diego , Calvo Núria , Campos-Balea Begoña , Carmona Marta , Cillan Elena , Díaz-Pedroche Carmen , Espinosa Olarte Paula , Exposito Francis , Fernández Isaura , Fernández-Franco Lourdes , Fullana Tomeu , García-Adrián Silvia , García-Sánchez Javier , Giménez Sandra , González-Cebrián Irene , González Moya Manuel , Lucía Gozálvez Clara , Gutiérrez-Abad David , Lage Yolanda , López Rosa , Luisa Limón María , Luque Raquel , Hernández Agustín , Horvath Evelin , López Rosa , Macias Ismael , Mangas Montse , Marco Pascual , Martí Edelmira , Martínez-del-Prado Purificación , Masvidal Maria , Meri Marina , Merino Marta , de Miguel Yolanda , Moragon Santiago , Morello Daniela , Obispo Berta , Pàmpols Montse , Pérez-Segura Pedro , Rivas Beatriz , Rodrigo Alberto , Ros Silverio , Sabino-Álvarez Araceli , Salgado Diego , Sánchez Raúl , Teijeira Lucía , Valero-Arbizu María , Vazquez Francisca , Carlos Villa Jose , Alves Paula , Amorim Júlia , Barros Anabela , Carvalho Carolina , Couto Nuno , Rita Garcia Ana , Gemas Vitória , Gosalbez Beatriz , Mansinho Hélder , Martinez Jorge , Peres Mafalda , Moreira Pinto António , Pulido Catarina , Raimundo Ana , João Ribeiro Maria 
Published: December 2024

Abstract

Background
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.

Patients and methods
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.

Results
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).

Conclusion
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.