Simple yet (more?) effective. Venous thromboembolism risk assessment model for germ cell tumour patients receiving first‐line chemotherapy

Abstract

Abstract Background Germ cell tumours (GCT) are highly curable malignancies. Venous thromboembolism (VTE) is a serious complication, needing better risk assessment models (RAM). Aim Identification of VTE incidence and risk factors in metastatic GCT patients starting first‐line chemotherapy. Developing a RAM and comparing it to Khorana risk score (KRS) and Padua Prediction Score (PPS). Material and methods We retrospectively analysed GCT patients staged IS–IIIC. VTE risk factors were identified with logistic regression. Area under curve of receiver operating characteristic (AUC‐ROC), Akaike and Bayesian Information Criteria (AIC, BIC) were calculated for the developed RAM, KRS and PPS. Results Among 495 eligible patients, VTE occurred in 69 (13.9%), including 40 prior to chemotherapy. Vein compression (OR: 8.96; 95% CI: 2.85–28.13; p 5 (OR 8.05; 95% CI 3.79–17.13; p < 0.001) correlated with VTE risk. Diagnostic criteria (AUC‐ROC, AIC, BIC) for the developed RAM, KRS and PPS were (0.885; 0.567; −1641), (0.588; 0.839; −1576) and (0.700; 0.799; −1585), respectively. In the numerical score, the optimal cut‐off point for high‐risk was ≥9, with sensitivity, specificity, positive and negative predictive value of 0.78, 0.77, 0.35 and 0.96, respectively. Conclusions Our RAM, based on vein compression, clinical stage and haemoglobin concentration proved superior to both KRS and PPS. VTE is frequent in GCT patients.

Keywords

• deep vein thrombosis
• germ cell cancer
• pulmonary embolism
• risk factors