Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Walser, G.
PRIMARY THROMBOPROPHYLAXIS AS RISK REDUCTION FOR THROMBOEMBOLIC EVENTS IN PATIENTS WITH TESTICULAR GERM CELL TUMOR UNDERGOING CISPLATINUM-BASED CHEMOTHERAPY
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 52
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Bauernhofer Thomas
- Terbuch Angelika
- Altmetrics:
- Abstract:
- Background: Testicular germ cell tumors (TGCT) commonly occur in young man aged 15-40 years. Due to the application of cisplatinum-based chemotherapies, the overall survival rate of patients with metastatic TGCT is excellent. The prevention of treatment-related complications has therefore become increasingly important. Cisplatinum-based chemotherapy is associated with an increased risk of venous thromboembolism (VTE). We hypothesized that primary thromboprophylaxis in patients with TGCT undergoing cisplatinum-based chemotherapy can reduce the risk of VTE. Patients and Methods: In this retrospective single-center cohort study we collected data from 1052 TGCT patients who were treated at the Department of Oncology at the Medical University of Graz between January 2000 and December 2021. 346 of these patients underwent cisplatinum-based chemotherapy either in adjuvant or in curative setting and were therefore included in this study. Results: 49 (14.2%) out of the included 346 patients developed VTE. The most significant indicator for VTE were a higher clinical tumor stage (cs IIC-III) and a retroperitoneal lymphadenopathy (RPLN) greater than 5cm in diameter (SHR for clinical stage IIC-IIIC: 2.6 (95% CI: 5.0-24.7, p<0.001), SHR for RPLN: 2.36 (95% CI: 1,27-4.4. p<0.007)). Since 2017, the application of primary thromboprophylaxis constantly increased and since 2019, all patients with clinical stage IIC-III disease received primary thromboprophylaxis in addition to cisplatinum-based chemotherapy. Primary thromboprophylaxis reduced the relative risk for VTE by 52% after adjusting for clinical tumor stage (SHR=0.48, 95% CI: 0.24-0.97, p=0.032). Conclusion: This study showed that the application of primary thromboprophylaxis in TGCT patients undergoing cisplatinum-based chemotherapy led to a significant reduction of VTE across all clinical tumor stages and should be considered on a risk-benefit ratio.