1. Large retroperitoneal lymphadenopathy and increased risk of venous thromboembolism in patients receiving first‐line chemotherapy for metastatic germ cell tumors: A study by the global germ cell cancer group (G3)
- Author
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Xavier Garcia del Muro, Alexey Tryakin, Anis A. Hamid, Daniel Castellano, Philippe L. Bedard, Enrique Gonzalez-Billalabeitia, Anna Patrikidou, Tina Cheng, Giovannella Palmieri, Carsten Bokemeyer, Robert Kitson, Christian D. Fankhauser, Christoph Seidel, Edmond M. Kwan, Margarida Brito, Margaret Ottaviano, Aude Flechon, Thomas Hermanns, Daniel Y.C. Heng, Eitan Amir, Jose Manuel Ruiz-Morales, Alison Reid, Alexey Rumyantsev, Ben Tran, University of Zurich, and Tran, Ben
- Subjects
0301 basic medicine ,Male ,Cancer Research ,pulmonary embolism ,medicine.medical_treatment ,Gastroenterology ,0302 clinical medicine ,Catheters, Indwelling ,Risk Factors ,Antineoplastic Combined Chemotherapy Protocols ,1306 Cancer Research ,Child ,Original Research ,education.field_of_study ,Middle Aged ,Neoplasms, Germ Cell and Embryonal ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Pulmonary embolism ,testicular cancer ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,2730 Oncology ,Vascular Access Devices ,Adult ,medicine.medical_specialty ,Adolescent ,Retroperitoneal Lymph Node ,Population ,venous thromboembolism ,610 Medicine & health ,Risk Assessment ,lcsh:RC254-282 ,deep vein thrombosis ,03 medical and health sciences ,Young Adult ,vascular access device ,Internal medicine ,medicine ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Radiology, Nuclear Medicine and imaging ,Retroperitoneal Neoplasms ,Retroperitoneal Space ,cardiovascular diseases ,education ,Testicular cancer ,Aged ,Retrospective Studies ,Chemotherapy ,business.industry ,Clinical Cancer Research ,germ cell tumor ,medicine.disease ,10062 Urological Clinic ,030104 developmental biology ,Germ cell tumors ,Metastatic Germ Cell Tumor ,Lymph Nodes ,Cisplatin ,business ,Venous thromboembolism - Abstract
Background Metastatic germ cell tumor (mGCT) patients receiving chemotherapy have increased risk of life‐threatening venous thromboembolism (VTE). Identifying VTE risk factors may guide thromboprophylaxis in this highly curable population. Methods Data were collected from mGCT patients receiving first‐line platinum‐based chemotherapy at 22 centers. Predefined variables included International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification, long‐axis diameter of largest retroperitoneal lymph node (RPLN), Khorana score, and use of indwelling vascular access device (VAD). VTE occurring at baseline, during chemotherapy and within 90 days, was analyzed. Results Data from 1135 patients were collected. Median age was 31 years (range 10‐74). IGCCCG risk was 64% good, 20% intermediate, and 16% poor. VTE occurred in 150 (13%) patients. RPLN >3.5 cm demonstrated highest discriminatory accuracy for VTE (AUC 0.632, P, Venous thromboembolism can cause morbidity in germ cell tumor patients receiving chemotherapy; large retroperitoneal lymphadenopathy (RPLN) and indwelling vascular access devices (VAD) are significant VTE risk factors. VAD insertion should be avoided and thromboprophylaxis can be considered for large RPLN.
- Published
- 2020