Venous Thromboembolism During Chemotherapy for Testicular Cancer: A Population-Based Study |
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| Affiliation: | 1. Division of Cancer Care and Epidemiology, Queen''s Cancer Research Institute, Kingston, Canada;2. Departments of Oncology, Queen''s University, Kingston, Canada;3. ICES, Queen''s University, Kingston, Canada;4. Department of Oncology, University of Calgary, Calgary, Canada;5. Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada;1. NHS England & Royal College of Radiologists, London, UK;2. Royal College of Radiologists, London, UK;1. Department of Clinical Oncology, Mount Vernon Cancer Centre, Northwood, UK;2. Department of Radiotherapy Physics, Mount Vernon Cancer Centre, Northwood, UK;3. Department of Acute Medicine, University Hospital Lewisham, London, UK;4. Department of Clinical Oncology, St Bartholomew''s Hospital, London, UK;5. Division of Cancer Sciences, The University of Manchester, Manchester, UK;1. Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Chongqing, China;2. Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, China |
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| Abstract: | AimsVenous thromboembolism (VTE) is a potential complication among germ cell tumour patients. We evaluated the incidence rate, timing and factors associated with VTE among patients with germ cell cancer in routine practice.Materials and methodsThe Ontario Cancer Registry was linked to electronic records of treatment to identify all cases of testicular cancer treated in Ontario during 2000–2010. Administrative databases were used to identify VTE in the 3 months before and 5 years after orchiectomy. We explored patient-, disease- and treatment-related factors associated with VTE among all patients as well as those with detailed chemotherapy records available.ResultsDuring 2000–2010, 2650 patients underwent orchiectomy for testicular cancer; among this cohort, 920 (33%) received chemotherapy. The VTE rate was 8% (69/920) among patients treated with chemotherapy and 0.6% (11/1730) among those without chemotherapy. Among the patients treated with chemotherapy who had VTE, 13% (9/69) occurred in the month before starting chemotherapy, 62% (42/69) in the first 3 months after starting and 25% thereafter. For patients who received three and four cycles, VTE rates were 8% (21/258) and 16% (19/121), respectively. In adjusted analyses, the only factor independently associated with VTE was increasing number of cycles (odds ratio 3.91 for four cycles, odds ratio 1.63 for three cycles (P = 0.022) compared with one to two cycles).ConclusionThis population-based study confirms findings from institutional case series regarding the high rate of VTE among patients with germ cell tumours treated with chemotherapy. Future studies should evaluate the extent to which VTE prophylactic strategies might mitigate this risk. |
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| Keywords: | Chemotherapy germ cell cancer population based thromboprophylaxis thrombosis |
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