title: Screening high-risk cancer patients for VTE: a prospective observational study.
abstract: BACKGROUND
  The utility of screening for venous thromboembolism (VTE) in cancer patients is unknown. We evaluated this in a prospective cohort study of cancer patients initiating a new chemotherapy regimen and deemed high-risk (score ≥3) based on a validated Risk Score.
  
  
  METHODS
  Patients were evaluated with baseline and Q4 (±1) week serial ultrasonography for up to 16 weeks; additionally, computed tomography scans for restaging were also evaluated for VTE.
  
  
  RESULTS
  The study population comprised 35 patients. Pancreatic and gastro-esophageal cancers were the most common diagnoses. Of these, 8 (23%) developed a VTE. This included 5 patients with DVT alone (14%), 1 patient with PE alone (3%) and 2 (6%) with both. Ultrasound examinations identified asymptomatic DVT in 9.3% of patients at baseline; 0% at weeks 4 and 8 and 5.6% at week 12. Restaging CT scans identified asymptomatic PE in one patient at week 6 and in one patient at week 9 with subsequent DVT at week 10.
  
  
  CONCLUSIONS
  Screening for asymptomatic VTE has not been previously used as a clinical strategy in ambulatory cancer patients. We report that one-tenth of patients at baseline had occult DVT and in this high-risk population, screening at baseline may be of value.
authors.affiliation: Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. Electronic address: Khorana@ccf.org.
authors.forename: Alok A
authors.initials: AA
authors.lastname: Khorana
authors.affiliation: Department of Radiology, University of Rochester, Rochester, NY, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Rubens
authors.affiliation: James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA; Department of Medicine, University of Rochester, Rochester, NY, USA.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Prevention; Risk factors; Screening; Venous thromboembolism