Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25050
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dc.contributor.authorFankhauser, Christian Daniel-
dc.contributor.authorTran, Ben-
dc.contributor.authorPedregal, Manuel-
dc.contributor.authorRuiz-Morales, José Manuel-
dc.contributor.authorGonzalez-Billalabeitia, Egon-
dc.contributor.authorPatrikidou, Anna-
dc.contributor.authorAmir, Eitan-
dc.contributor.authorSeidel, Christoph-
dc.contributor.authorBokemeyer, Carsten-
dc.contributor.authorHermanns, Thomas-
dc.contributor.authorRumyantsev, Alexey-
dc.contributor.authorTryakin, Alexey-
dc.contributor.authorBrito, Margarida-
dc.contributor.authorFléchon, Aude-
dc.contributor.authorKwan, Edmon M-
dc.contributor.authorCheng, Tina-
dc.contributor.authorCastellano, Daniel-
dc.contributor.authorDel Muro, Xavier Garcia-
dc.contributor.authorHamid, Anis A-
dc.contributor.authorOttaviano, Margaret-
dc.contributor.authorPalmieri, Giovanella-
dc.contributor.authorKitson, Robert-
dc.contributor.authorReid, Alison-
dc.contributor.authorHeng, Daniel Y C-
dc.contributor.authorBedard, Philippe L-
dc.contributor.authorSweeney, Christopher J-
dc.contributor.authorConnors, Jean M-
dc.date2020-10-05-
dc.date.accessioned2020-10-15T03:16:43Z-
dc.date.available2020-10-15T03:16:43Z-
dc.date.issued2021-09-
dc.identifier.citationEuropean urology focus 2021; 7(5): 1130-1136en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/25050-
dc.description.abstractIt remains unclear which patients with metastatic germ cell tumours (mGCTs) need prophylactic anticoagulation to prevent venous thromboembolic events (VTEs). To assess the risk and onset of VTEs stratified by risk factors. This multi-institutional retrospective dataset included mGCT patients treated with first-line platinum-based chemotherapy. Patients with prophylactic anticoagulation were excluded. A regression analysis was performed to select risk factors for VTEs. The simulated number needed to treat (NNT) and the number needed to harm (NNH) with prophylactic anticoagulation were calculated based on the cumulative incidences retrieved from this study and hazard rates of recently published trials describing the efficacy of prophylactic anticoagulation to prevent VTEs and the risk of bleeding events. From 1120 patients, 121 (11%) had a VTE, which occurred prior to chemotherapy in 49 (4%) and on or after chemotherapy in 72 (6%). Six patients (<1%) had a bleeding event without anticoagulation. After backward regression, the one risk factor for a VTE during or after chemotherapy was the use of a venous access device. The simulated cumulative VTE incidence from prophylactic anticoagulation for patients on or after chemotherapy would translate into an NNT of 45 (95% confidence interval [CI] 36-56) and an NNH of 186 (95% CI 87-506). Limitations are mainly related to the retrospective nature of the study. The mGCTs associated VTEs are most common before and during, but not after, chemotherapy. Avoiding venous access device and/or prophylactic anticoagulation with an acceptable risk-benefit profile may decrease VTE occurring on chemotherapy. We found that venous thromboembolic events (VTEs) occur rarely after chemotherapy. Based on experience of prophylactic anticoagulation in other cancers, we conclude that the risk of VTE in men undergoing chemotherapy for metastatic germ cell tumours can be decreased by thromboprophylaxis with a reasonable risk-benefit profile and by avoidance of venous access devices.en
dc.language.isoeng-
dc.subjectDeep vein thrombosisen
dc.subjectGerm cell tumouren
dc.subjectPulmonary embolismen
dc.subjectTesticular canceren
dc.subjectVenous access deviceen
dc.subjectVenous thromboembolismen
dc.titleA Risk-benefit Analysis of Prophylactic Anticoagulation for Patients with Metastatic Germ Cell Tumours Undergoing First-line Chemotherapy.en
dc.typeJournal Articleen
dc.identifier.journaltitleEuropean Urology Focusen
dc.identifier.affiliationUniversity Hospital Zurich, University of Zurich, Zurich, Switzerlanden
dc.identifier.affiliationHematology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAen
dc.identifier.affiliationOlivia Newton-John Cancer Wellness and Research Centreen
dc.identifier.affiliationPeter MacCallum Cancer Centre, Melbourne, Australiaen
dc.identifier.affiliationTom Baker Cancer Centre, Calgary, Alberta, Canadaen
dc.identifier.affiliationDivision of Medical Oncology & Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Ontario, Canadaen
dc.identifier.affiliationDana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USAen
dc.identifier.affiliationHospital Universitario Morales Meseguer-IMIB, UCAM, Murcia, Spainen
dc.identifier.affiliationThe Royal Marsden NHS Foundation Trust, London, UKen
dc.identifier.affiliationDepartment of Oncology, Hematology, BMT with Division of Pneumology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germanyen
dc.identifier.affiliationUniversity Hospital Zurich, University of Zurich, Zurich, Switzerlanden
dc.identifier.affiliationNN Blokhin Russian Cancer Research Centre, Moscow, Russiaen
dc.identifier.affiliationInstituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugalen
dc.identifier.affiliationCentre Léon Bérard, Lyon, Franceen
dc.identifier.affiliationInstitut Catala d'Oncologia, Idibell, University of Barcelona, Barcelona, Spain; Department of Oncology, Hospital Universitario 12 de octubre, Madrid, Spainen
dc.identifier.affiliationInstitut Catala d'Oncologia, Idibell, University of Barcelona, Barcelona, Spainen
dc.identifier.affiliationCRTR Rare Tumors Reference Center, Università Degli Studi di Napoli Federico II, Naples, Italyen
dc.identifier.affiliationThe Royal Marsden NHS Foundation Trust, London, UKen
dc.identifier.affiliationDana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USAen
dc.identifier.doi10.1016/j.euf.2020.09.017en
dc.type.contentTexten
dc.identifier.pubmedid33032968-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
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