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09-05-2024 | RESEARCH ARTICLE

External validation of the RIETE and SOME scores for occult cancer in patients with venous thromboembolism: a multicentre cohort study

Authors: Anabel Franco-Moreno, José Bascuñana Morejón-Girón, Paloma Agudo-Blas, Cristina Lucía de Ancos-Aracil, Nuria Muñoz-Rivas, Ana Isabel Farfán-Sedano, Justo Ruiz-Ruiz, Juan Torres-Macho, Ana Bustamante-Fermosel, Nuria Alfaro-Fernández, José Manuel Ruiz-Giardín, Elena Madroñal-Cerezo

Published in: Clinical and Translational Oncology

Abstract

Introduction

Venous thromboembolism (VTE) may be the first sign of an undiagnosed cancer. The RIETE and SOME scores aim to identify patients with acute VTE at high risk of occult cancer. In the present study, we evaluated the performance of both scores.

Methods

The scores were evaluated in a retrospective cohort from two centers. The area under the receiver-operating characteristics curve (AUC) evaluated the discriminatory performance.

Results

The RIETE score was applied to 815 patients with provoked and unprovoked VTE, of whom 56 (6.9%) were diagnosed with cancer. Of the 203 patients classified as high-risk, 18 were diagnosed with cancer, representing 32.1% (18/56) of the total cancer diagnoses. In the group of 612 low-risk patients, 67.9% of the cancer cases were diagnosed (38/56). Sensitivity, specificity, negative and positive predictive values, and AUC were 32%, 76%, 94%, 9%, and 0.430 (95% confidence interval [CI], 0.38‒0.47), respectively. The SOME score could be calculated in 418 patients with unprovoked VTE, of whom 33 (7.9%) were diagnosed with cancer. Of the 45 patients classified as high-risk, three were diagnosed with cancer, representing 9.1% (3/33) of the total cancer diagnoses. In the group of 373 low-risk patients, 90.9% of the cancer cases were diagnosed (30/33). Sensitivity, specificity, negative and positive predictive values, and AUC were 33%, 88%, 94%, 20%, and 0.351 (95% CI, 0.27‒0.43), respectively.

Conclusions

The performance of both scores was poor. Our results highlight the need to develop new models to identify high-risk patients who may benefit from an extensive cancer screening strategy.

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Title: External validation of the RIETE and SOME scores for occult cancer in patients with venous thromboembolism: a multicentre cohort study
Authors: Anabel Franco-Moreno
José Bascuñana Morejón-Girón
Paloma Agudo-Blas
Cristina Lucía de Ancos-Aracil
Nuria Muñoz-Rivas
Ana Isabel Farfán-Sedano
Justo Ruiz-Ruiz
Juan Torres-Macho
Ana Bustamante-Fermosel
Nuria Alfaro-Fernández
José Manuel Ruiz-Giardín
Elena Madroñal-Cerezo
Publication date: 09-05-2024
Publisher: Springer International Publishing
Published in: Clinical and Translational Oncology
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-024-03500-w

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