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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 | 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: | https://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 |
Journal: | Cancer medicine | 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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