1 Prediction of venous thromboembolism in cancer patients

The risk of venous thromboembolism (VTE) is increased in cancer patients. To improve prediction of VTE in cancer patients, we performed a prospective and observational cohort study of patients with newly diagnosed cancer or progression of disease after remission. A previously developed risk scoring model for prediction of VTE that included clinical (tumour entity and body-mass-index) and laboratory (hemoglobin level, thrombocyte- and leucocyte-count) parameters was expanded by incorporating two biomarkers, soluble P-selectin and D-dimer. Of 819 patients 61 (7.4%) experienced VTE during a median follow-up of 656 days. The cumulative VTE probability in the original risk model after 6 months was 17.7 % in patients with the highest risk score (≥3, n=93), 9.6 % in those with score 2 (n=221), 3.8 % in those with score 1 (n=229) and 1.5 % in those with score 0 (n=276). In the expanded risk model, the cumulative VTE probability after 6 months in patients with the highest score (≥5, n=30) was 35.0 % and 10.3 % in those with an intermediate score (score 3, n=130) as opposed to only 1.0 % in patients with score 0 (n=200); the hazard ratio of patient