Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22144
Title: 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).
Austin Authors: Tran, Ben;Ruiz-Morales, Jose M;Gonzalez-Billalabeitia, Enrique;Patrikidou, Anna;Amir, Eitan;Seidel, Christoph;Bokemeyer, Carsten;Fankhauser, Christian;Hermanns, Thomas;Rumyantsev, Alexey;Tryakin, Alexey;Brito, Margarida;Fléchon, Aude;Kwan, Edmond Michael;Cheng, Tina;Castellano, Daniel;Garcia Del Muro, Xavier;Hamid, Anis A;Ottaviano, Margaret;Palmieri, Giovannella;Kitson, Robert;Reid, Alison;Heng, Daniel Y C;Bedard, Philippe L
Affiliation: Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Tom Baker Cancer Centre, Calgary, AB, Canada
Hospital Universitario Morales Meseguer - IMIB, UCAM, Murcia, Spain
Royal Marsden Hospital, London, UK
Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
Department of Oncology, Hematology, BMT with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
University Hospital Zurich, University of Zurich, Zurich, Switzerland
NN Blokhin Russian Cancer Research Centre and Research Institute of Oncology at BSMU, Moskva, Russia
Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
Centre Léon Bérard, Lyon, France
Hospital Universitario 12 de Octubre, Madrid, Spain
Institut Catala d'Oncologia, Idibell, University of Barcelona, Barcelona, Spain
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
CRTR Rare Tumors Reference Center, Università Degli Studi di Napoli Federico II, Napoli, Italy
Issue Date: Jan-2020
metadata.dc.date: 2019-11-12
Publication information: Cancer medicine 2020; 9(1): 116-124
Abstract: 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. 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. 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 < .001) and was associated with significantly higher risk of VTE in univariable analysis (22% vs 8%, OR 3.0, P < .001) and multivariable analysis (OR 1.8, P = .02). Other significant risk factors included, Khorana score ≥3 (OR 2.6, P = .008) and VAD use (OR 2.7, P < .001). Large RPLN and VAD use are independent risk factors for VTE in mGCT patients receiving chemotherapy. VAD use should be minimized in this population and thromboprophylaxis might be considered for large RPLN.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22144
DOI: 10.1002/cam4.2674
ORCID: 0000-0001-9124-354X
0000-0003-3143-3143
0000-0002-6771-2999
0000-0002-0376-2559
PubMed URL: 31715650
Type: Journal Article
Subjects: deep vein thrombosis
germ cell tumor
pulmonary embolism
testicular cancer
vascular access device
venous thromboembolism
Appears in Collections:Journal articles

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