Open AccessLarge 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(s) -
Tran Ben,
RuizMorales Jose M.,
GonzalezBillalabeitia 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.
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2674
Subject(s) - medicine , chemotherapy , germ cell tumors , venous thromboembolism , surgery , population , cancer , oncology , thrombosis , environmental health
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 < .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). Conclusions 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.