Predictive risk scales for venous thromboembolism in outpatients with solid tumors

Abstract

Summary. Introduction. Venous thromboembolic events (VTE) frequently manifest in cancer patients, especially during the early phase following clinical diagnosis. Thrombotic episodes have been demonstrated to be associated with a worsening prognosis, a reduction in quality of life, and significant treatment costs. Although thromboprophylaxis in high-risk cancer patients during hospitalization and in the perioperative period has been incorporated into routine practice and is supported by clinical guidelines, its use in outpatient settings is limited. Mathematical modeling techniques in the development of risk scales have been demonstrated to facilitate decision-making processes concerning thromboprophylaxis. Nevertheless, the evaluation of the VTE likelihood remains challenging. Aim: to summarize current scientific data on VTE risk assessment in outpatient cancer patients with solid tumors using traditional multifactorial prognostic scales. Materials and Methods. The study was based on the collection and analysis of publications from scientific databases PubMed/MEDLINE, Google Scholar, and eLibrary for the period 2005–2025 using keywords in Russian and English. Following the exclusion of duplicates and irrelevant works, 41 publications were included in the final analysis of the 512 sources. The present study focuses on scales with sensitivity, specificity, and AUC (area under curve) assessments. Results. The Khorana risk score scale is recognized as the most validated tool for assessing VTE risk in patients receiving outpatient anticancer therapy, and recommendations for its use are reflected in leading clinical guidelines. Furthermore, the development and validation of scales (COMPASS-CAT, Vienna CATS) enable VTE risk assessment in specific patient demographics. Conclusion. It is imperative to acknowledge that thrombosis prevention constitutes an integral component of comprehensive treatment for cancer patients, thereby enhancing the efficacy of therapeutic interventions and ultimately contributing to the enhancement of disease outcomes. Prognostic scales constitute a pivotal instrument in the context of individualized decisions pertaining to the prescription of anticoagulant thromboprophylaxis. A significant domain of scientific inquiry pertains to the supplementary external validation of risk-oriented models, founded on a synthesis of clinical signs, genetic polymorphisms and laboratory biomarkers in prospective studies. This encompasses the formulation of novel scales using contemporary mathematical methodologies, encompassing artificial intelligence.

For citation: Ovchinnikova M.A., Vlasov V.S., Dyakonenko Z.V., Osipov N.N., Spelnikov D.М., Belevitin A.B., Vavilova T.V. Predictive risk scales for venous thromboembolism in outpatients with solid tumors. Tromboz, gemostaz i reologiya. 2026;(1):4–20. (In Russ.).

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