779PD - Large retroperitoneal lymphadenopathy (RPLN) and increased risk of venous thromboembolism (VTE) in patients (pts) with metastatic germ cell tumours...

Date 09 October 2016
Event ESMO 2016 Congress
Session Genitourinary tumours, non-prostate
Topics Germ Cell Tumours
Presenter Ben Tran
Citation Annals of Oncology (2016) 27 (6): 266-295. 10.1093/annonc/mdw373
Authors B. Tran1, J.M. Ruiz-Morales2, E. González Billalabeitia3, E. Amir4, C. Seidel5, C. Bokemeyer5, C. Fankhauser6, T. Hermanns6, A. Rumyantsev7, A. Tryakin7, M. Brito8, A. Flechon9, D. Castellano10, X. Garcia del Muro11, A. Hamid12, G. Palmieri13, R. Kitson14, A. Reid14, D. Heng15, P. Bedard4
  • 1Medical Oncology, The Royal Melbourne Hospital, 3050 - Parkville/AU
  • 2Medical Oncology, Tom Baker Cancer Centre, Calgary/CA
  • 3Servicio De Hematología Y Oncología Médica, Hospital Universitario Morales Meseguer, Murcia/ES
  • 4Medical Oncology, Princess Margaret Hospital, M5G 2M9 - Toronto/CA
  • 5Dept. Hemato/oncology, UKE Universitätsklinikum Hamburg-Eppendorf KMTZ, 20246 - Hamburg/DE
  • 6Department Of Urology, University Hospital Zürich, Zürich/CH
  • 7Medical Oncology, N. N. Blokhin Russian Cancer Research Center, Moscow/RU
  • 8Medical Oncology, Instituto Portuguès de Oncologia de Lisboa Francisco Gentil, E.P.E. (IPOLFG EPE), Lisboa/PT
  • 9Medical Oncology, Centre Léon Bérard, Lyon/FR
  • 10Medical Oncology, University Hospital 12 De Octubre, Madrid/ES
  • 11Medical Oncology, Institut Català d'Oncologia Hospital Duran i Reynals, Barcelona/ES
  • 12Medical Oncology, Austin Hospital, Heidelberg/AU
  • 13Medical Oncology, Università Degli Studi di Napoli Federico II, Napoli/IT
  • 14Medical Oncology, Royal Marsden Hospital NHS Foundation Trust, London/GB
  • 15Medical Oncology, Tom Baker Cancer Centre, T2N 4N2 - Calgary/CA



Prior data indicate that large RPLN significantly increases the risk of VTE in pts with mGCT receiving first line platinum based chemotherapy (chemo). The aim of this multinational G3 study was to validate large RPLN as a risk factor for VTE and evaluate other predictive factors.


Data were collected retrospectively from sequential pts with mGCT receiving first line chemo from 2000-2014 at 22 centres. Pre-defined variables of interest included IGCCCG risk classification, axial long axis diameter of largest RPLN, Khorana score (validated predictor for chemo associated VTE), LDH, prior VTE and presence of venous access device (VAD). VTE occurring at baseline, during chemo and within 90 days of completion were analysed. Pts receiving thromboprophylaxis (TP) were excluded. Predictive accuracy was assessed using logistic regression and discriminatory accuracy explored using area under the receiver operating curve (AUC).


Data from 1135 pts were collected. Median age was 31 (range 10-74). Testicular primary (92%), non-seminoma histology (72%) and BEP chemo (82%) were most common. IGCCCG risk distribution was 64% good, 20% intermediate and 16% poor. VTE occurred in 150 pts (13%). RPLN >3.5cm demonstrated highest discriminatory accuracy (AUC 0.68, p 3.5cm was associated with significantly higher risk of VTE (22% versus 8%, OR 3.4, p 


This study confirms large RPLN (>3.5cm) as an independent risk factor for VTE in mGCT pts receiving first line chemo. Prospective trials examining TP in this high risk population are warranted.

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Legal entity responsible for the study





All authors have declared no conflicts of interest.