Prognostic Significance of Venous Thromboembolic Events in Disseminated Germ Cell Cancer Patients
| العنوان: | Prognostic Significance of Venous Thromboembolic Events in Disseminated Germ Cell Cancer Patients |
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| المؤلفون: | Antonio Fernández, Jose Luis Aguilar, Pablo Cerezuela, A. Saenz, S. Ros, Alberto Carmona-Bayonas, Sara Fernández, Claudia Valverde, Daniel Castellano, Mireia Margeli, David Hervás, Xavier Garcia del Muro, Grupo Germinal, Francisco Ayala de la Peña, Josep Guma, Javier Sastre, Ignacio Duran, Begoña Mellado, Samuel Rivera, Nora Sobrevilla, Alfonso Sanchez-Muñoz, Jose R. Germa-Lluch, Enrique Gonzalez-Billalabeitia, Ray Manneh, Maria Isabel Luengo, Pablo Maroto, Jorge Aparicio |
| المساهمون: | [Gonzalez-Billalabeitia, Enrique] Hosp Univ Morales Meseguer IMIB, Murcia, Spain, [Luengo, Maria I.] Hosp Univ Morales Meseguer IMIB, Murcia, Spain, [Gonzalez-Billalabeitia, Enrique] Univ Catolica San Antonio Murcia UCAM, Murcia, Spain, [Castellano, Daniel] Hosp Univ 12 Octubre, Madrid, Spain, [Manneh, Ray] Hosp Univ 12 Octubre, Madrid, Spain, [Sobrevilla, Nora] Inst Nacl Cancerol, Mexico City, DF, Mexico, [Guma, Josep] URV, Hosp San Joan de Reus, IISSPV, Tarragona, Spain, [Hervas, David] Inst Invest Sanitaria La Fe, Valencia, Spain, [Aparicio, Jorge] Hosp Univ La Fe, Valencia, Spain, [Sanchez-Munoz, Alfonso] Hos Univ Reg & Virgen de la Victoria Malaga, Invest Clin & Traslac Canc, Inst Invest Biomed Malaga IBIMA, Malaga, Spain, [Mellado, Begona] Hosp Clin Barcelona, IDIBAPS, Serv Oncol Med, Barcelona, Spain, [Saenz, Alberto] Hosp Clin Lozano Blesa, Zaragoza, Spain, [Valverde, Claudia] Hosp Univ Vall dHebron, Barcelona, Spain, [Fernandez, Antonio] Complejo Hosp Univ Albacete, Albacete, Spain, [Margeli, Mireia] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol, Badalona, Spain, [Duran, Ignacio] Hosp Univ Virgen del Rocio, Seville, Spain, [Fernandez, Sara] Hosp Cent Asturias, Oviedo, Spain, [Sastre, Javier] Hosp Clin San Carlos, Madrid, Spain, [Ros, Silverio] Hosp Virgen Arrixaca, Murcia, Spain, [Maroto, Pablo] Hosp Santa Creu & Sant Pau, Barcelona, Spain, [Cerezuela, Pablo] Hosp Santa Lucia, Cartagena, Spain |
| المصدر: | JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe instname |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Risk, 0301 basic medicine, Oncology, Adult, Male, Cancer Research, medicine.medical_specialty, Pathology, Prognostic variable, Survival, Adolescent, medicine.medical_treatment, Disease-Free Survival, 03 medical and health sciences, Bleomycin, Young Adult, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Registries, Young adult, Child, Survival rate, Tumors, Aged, Etoposide, Proportional Hazards Models, Chemotherapy, business.industry, Proportional hazards model, Hazard ratio, Venous Thromboembolism, Middle Aged, Neoplasms, Germ Cell and Embryonal, Prognosis, Confidence interval, Cisplatin-based chemotherapy, Survival Rate, 030104 developmental biology, 030220 oncology & carcinogenesis, Cohort, Female, Cisplatin, business, Follow-Up Studies |
| الوصف: | Background: Disseminated germ cell cancers are at high risk of developing thromboembolic complications. We evaluated the prognostic value of venous thromboembolic events (VTE) in disseminated germ cell cancer. Methods: Patients with germ cell cancer receiving upfront platinum-containing chemotherapy between 2004 and 2014 were pooled from the Spanish Germ Cell Cancer Group (SGCCG) registry and reviewed for the presence of VTE. Results were validated in an independent international group of patients. We used a penalized Cox proportional hazards model including VTE as a time-varying covariate to identify and validate prognostic factors. All statistical tests were two-sided. Results: The SGCCG registry identified 416 patients from 14 referral institutions. With a median follow-up of 49 months, VTEs were observed in 9% of patients (n = 38). Events occurred at diagnosis, during chemotherapy, and after chemotherapy in 2.6%, 5.0%, and 1.4% of patients, respectively. VTE was associated with shorter progression-free survival (PFS; hazard ratio [HR] = 2.29, 95% confidence interval [CI] = 1.18 to 4.47, P = .02) and overall survival (OS; HR = 5.14, 95% CI = 2.22 to 11.88, P < .001). In multivariable analysis, the effect was consistent in the intermediate-risk group, both for PFS (HR = 9.52 95% CI = 2.48 to 36.58, P < .001) and OS (HR = 12.84, 95% CI = 2.01 to 82.02, P = .007). VTE at diagnosis is also an adverse prognostic variable for progression-free survival (HR = 4.64, 95% CI = 2.04 to 10.54, P < .001) and for overall survival (HR = 6.28, 95% CI = 1.68 to 17.10, P = .01). These results were validated in an independent international cohort that included 241 patients from four hospitals. Conclusions: VTE is an independent adverse prognostic factor in disseminated germ cell cancers, in particular for the intermediate prognostic group of the International Germ Cell Cancer Collaborative Group classification. The presence of VTE at diagnosis has also prognostic significance and should be further explored in future prognostic classifications. |
| اللغة: | English |
| تدمد: | 0027-8874 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cdaf539679430e46f25ee5ae30f54be3Test https://hdl.handle.net/10668/10808Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....cdaf539679430e46f25ee5ae30f54be3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00278874 |
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