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Terbuch, A; Walser, G; Stotz, M; Gerger, A; Posch, F; Bauernhofer, T.
Primary Thromboprophylaxis and the Risk of Venous Thromboembolic Events in Patients With Testicular Germ Cell Tumors Treated With Cisplatinum-Based Chemotherapy.
Clin Genitourin Cancer. 2023; 21(1):24-31 Doi: 10.1016/j.clgc.2022.10.005
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Führende Autor*innen der Med Uni Graz
Posch Florian
Terbuch Angelika
Co-Autor*innen der Med Uni Graz
Bauernhofer Thomas
Gerger Armin
Stotz Michael
Walser Gudrun Irmgard Magdalena
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Abstract:
BACKGROUND: Cisplatinum-based chemotherapy is associated with an increased risk of venous thromboembolism (VTE). We hypothesized that primary thromboprophylaxis in patients with testicular germ cell tumors (GCT) undergoing cisplatinum-based chemotherapy can reduce the risk of VTE. PATIENTS AND METHODS: In this single-center retrospective cohort study, we investigated the increased use of primary thromboprophylaxis between January 2000 and December 2021 at our institution and its effect on the risk of VTE. Patients with GCT undergoing adjuvant or curative cisplatinum-based chemotherapy were included. RESULTS: Three hundred forty-six patients with GCT initiating a cisplatinum-based therapy were included in the study, of whom 122 (35%) were treated in the adjuvant and 224 (65%) in the curative setting, respectively. VTE events occurred in 49 (14.2%) patients. In univariable competing risk analysis, a higher clinical tumor stage and large retroperitoneal lymphadenopathy (RPLND >5 cm) were the strongest predictors of an elevated VTE risk (SHR for stage IIC - IIIC: 2.6 (95%CI: 5.0-24.7, P < .001), SHR for RPLN: 2.36 (95%CI: 1.27-4.4, P < .007)). The proportion of patients receiving primary thromboprophylaxis strongly increased over time and reached 100% in CS IIC-III patients from 2019 onwards. After adjusting for tumor stage, primary thromboprophylaxis was associated with a 52% relatively lower risk of VTE (SHR = 0.48, 95% CI: 0.24-0.97; P = .032). CONCLUSION: In this retrospective cohort study, we showed that TGCT patients undergoing cisplatinum-based chemotherapy have a lower VTE risk when receiving primary thromboprophylaxis. For the duration of chemotherapy, primary thromboprophylaxis should be considered on a risk-benefit ratio.
Find related publications in this database (using NLM MeSH Indexing)
Male - administration & dosage
Humans - administration & dosage
Venous Thromboembolism - chemically induced, epidemiology
Anticoagulants - therapeutic use
Heparin, Low-Molecular-Weight - adverse effects
Retrospective Studies - administration & dosage
Venous Thrombosis - administration & dosage
Testicular Neoplasms - drug therapy
Neoplasms, Germ Cell and Embryonal - drug therapy
Cisplatin - adverse effects

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