March 15, 2022

Improving care for gynecologic cancer

To reduce risk of deep vein thrombosis in patients being treated for gynecologic cancer, Vanderbilt researchers recommend that providers use Khorana scores and provide prophylactic treatment according to clinical guidelines.

by Emily Stembridge

Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality in patients with gynecologic cancer.

Alaina Brown, MD and colleagues sought to evaluate the efficacy of an initiative to improve provider compliance with the American Society of Clinical Oncology (ASCO) guidelines for VTE chemoprophylaxis in patients with gynecologic cancer receiving chemotherapy.

Using Khorana scores — a tool for predicting the risk of VTE — the research team identified patients eligible for chemoprophylaxis. None of the identified patients who received chemoprophylaxis developed VTE within six months of starting chemotherapy. Although previous literature has not thoroughly evaluated Khorana score in gynecologic patients, the researchers found patients with increased Khorana score were at higher risk for VTE, particularly those with scores of three or greater.

Brown and colleagues conclude in the International Journal of Gynecological Cancer that notifying providers of a patient’s Khorana score improves compliance with ASCO guidelines for VTE chemoprophylaxis among chemotherapy patients and mitigates risk for VTE.

This study was funded by the National Institutes of Health (grant TR000445).