Large retroperitoneal lymph node (RPLN) is associated with venous thromboembolism (VTE) in patients with disseminated germ cell tumors (GCTs), providing better accuracy than high-risk Khorana score in this group, according to a recent study published in the Journal of Clinical Oncology.
Amirrtha Srikanthan, MD, of the Princess Margaret Cancer Centre in Toronto and fellow researchers looked at a training cohort of 216 patients with disseminated GCT who were receiving first-line chemotherapy from January 2000 to December 2010, with large RPLN defined as more than 5 centimeters in diameter.
Comparing predictive models using large RPLN with high-risk Khorana score in order to determine risk of VTE, the researchers found that the former method showed higher discriminatory accuracy, with further validation in a London cohort.
Twenty-one patients developed VTE during chemotherapy, and it was associated with large RPLN, high-risk Khorana score, intermediate- to poor-risk disease, and hospitalization.
“Prophylactic anticoagulation may be considered in high-risk patients,” the authors concluded. “Results should be validated in larger, prospective studies.”
The researchers hypothesized that there was an association between large RPLN and chemotherapy-associated VTE risk. Large RPLN is associated with VTE in patients with disseminated GCT and provides higher discriminatory accuracy than high-risk Khorana score.