Influence of type 2 diabetes mellitus on Khorana venous thromboembolism risk in colorectal cancer patients
2017
Background: Many studies have documented the association
between venous thromboembolism (VTE) and colorectal cancer
(CRC). The Khorana model is a VTE risk assessment model for
predicting cancer-associated thrombosis. Type 2 diabetes (T2DM)
has also been reported to increase the risk of VTE.
Purpose: The aim of this study was to investigate the influence
of T2DM on Khorana VTE risk in CRC patients and to explore
the relationship between Khorana VTE category and CRC
clinicopathological factors.
Methods: This analysis included 615 CRC patients (205 with
T2DM). Fibrinogen and D-dimer levels were compared within
each group. A comparison was made of the proportion of patients
in different Khorana VTE risk categories in CRC patients with
and without T2DM. The association between Khorana VTE risk
category and clinicopathological factors among all the CRC patients
was evaluated.
Results: Fibrinogen levels of CRC patients with T2DM were
significantly higher than those of non-diabetes patients (4.13 ±
1.06 vs 3.94 ± 0.98, p < 0.001). A higher proportion of CRC
patients with T2DM were in the Khorana intermediate-to-high risk
category (H = 4.749, p = 0.029). Female sex, diabetes, colon
location (compared with rectum), larger tumor size, advanced pT
stage and pN stage were correlated with the intermediate-to-high
Khorana VTE risk category, with odd ratios (95% confidence
intervals [CI]) of 1.537 (1.064-2.220), 1.499 (1.027-2.186), 2.313
(1.588-3.370), 2.284 (1.542-3.383), 4.429 (2.088-9.396) and
1.822 (1.230-2.698), respectively.
Conclusion: T2DM increases Khorana VTE risk in CRC
patients. Female sex, diabetes, colon location, large tumor size and
poor stage are associated with the intermediate-to-high Khorana
VTE risk category.
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