Published online Oct 15, 2023. doi: 10.4251/wjgo.v15.i10.1784
Peer-review started: June 15, 2023
First decision: August 7, 2023
Revised: August 21, 2023
Accepted: September 18, 2023
Article in press: September 18, 2023
Published online: October 15, 2023
The Khorana risk score (KRS) has poor predictive value for cancer-associated thrombosis in a single tumor type but is associated with early all-cause mortality from cancer. Evidence for the association between KRS and all-cause mortality in Japanese patients with gastric and colorectal cancer is limited.
To investigate whether KRS was independently related to all-cause mortality in Japanese patients with gastric and colorectal cancer after adjusting for other covariates and to shed light on its temporal validity.
Data from Dryad database were used in this study. Patients in the Gastroenterology Department of Sapporo General Hospital, Sapporo, Japan, were enrolled. The starting and ending dates of the enrollment were January 1, 2008 and January 5, 2015, respectively. The cutoff date for follow-up was May 31, 2016. The inde
Men and patients with Eastern Cooperative Oncology Group Performance Status (ECOG PS) ≥ 2 displayed a higher 2-year risk of death than women and those with ECOG PS 0-1 in the intermediate/high risk group for KRS. The higher the score, the higher the risk of early death; however, the relevance of this independent prediction decreased with longer survival. The overall survival of each patient was recorded via real-world follow-up and retrospective observations, and this study yielded the overall relationship between KRS and all-cause mortality.
The prechemotherapy baseline of KRS was independently associated with all-cause mortality within 2 years; however, this independent predictive relationship weakened as survival time increased.
Core Tip: The Khorana risk score (KRS) has poor predictive value for cancer-associated thrombosis in a single tumor type but is associated with early all-cause mortality from cancer. In Japanese patients with gastric and colorectal cancer, the prechemotherapy baseline of KRS was independently associated with all-cause mortality within 2 years. The concept of time-sensitive management needs to be established for clinicians and community workers as well. The earlier the stratified intervention for patients with intermediate/high KRS, the more likely long-term survival benefit will be achieved.