Tim Nestler1,2, Johannes Huber3, Adrienne M Laury4, Hendrik Isbarn5, Axel Heidenreich6, Hans U Schmelz7, Christian G Ruf7. 1. Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany. tim-nestler@web.de. 2. Department of Urology, University Hospital Cologne, Cologne, Germany. tim-nestler@web.de. 3. Department of Urology, University Hospital Dresden, Dresden, Germany. 4. Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Fort Sam Houston, Texas, USA. 5. Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 6. Department of Urology, University Hospital Cologne, Cologne, Germany. 7. Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany.
Abstract
PURPOSE: Due to the excellent cure rates for testicular cancer (TC), focus has shifted towards decreasing therapy-related morbidities. Thrombosis is a frequent complication of cisplatin chemotherapy. Furthermore, the optimal route of administration for chemotherapy is still under debate. The purpose of this study was to assess the patterns of care concerning dosing and duration of thromboprophylaxis currently utilized in TC patients in German-speaking countries as well as the route of chemotherapy administration. METHODS: A standardized questionnaire was sent to all members of the German TC Study Group (GTCSG) and to all the urological university hospitals in Germany. The questionnaire was also sent to the oncologic clinics at those universities where urologists do not administer chemotherapy. RESULTS: The response rate was 87% (55/63). Prophylactic anticoagulation with low-molecular-weight heparin (LMWH) was administered in 94% of the clinics. The dosing of LMWH was prophylactic (85%), high prophylactic (adjusted to bodyweight) (7%), or risk adapted (9%). After completion of chemotherapy, anticoagulation was continued in 15 clinics (33%) for 2 to 24 weeks, while the remainder stopped the LMWH upon cessation of chemotherapy. Chemotherapy was administered via central venous access in 59%, peripheral IV in 27%, or both in 14% of the clinics. CONCLUSIONS: Most of the institutions performed some form of thromboprophylaxis, although the modes of application varied by institution type and amongst the urologists and oncologists. Prospective studies are needed to evaluate the incidence, date of occurrence, and risk factors of venous thrombosis during TC chemotherapy to provide a recommendation concerning prophylactic anticoagulation.
PURPOSE: Due to the excellent cure rates for testicular cancer (TC), focus has shifted towards decreasing therapy-related morbidities. Thrombosis is a frequent complication of cisplatin chemotherapy. Furthermore, the optimal route of administration for chemotherapy is still under debate. The purpose of this study was to assess the patterns of care concerning dosing and duration of thromboprophylaxis currently utilized in TC patients in German-speaking countries as well as the route of chemotherapy administration. METHODS: A standardized questionnaire was sent to all members of the German TC Study Group (GTCSG) and to all the urological university hospitals in Germany. The questionnaire was also sent to the oncologic clinics at those universities where urologists do not administer chemotherapy. RESULTS: The response rate was 87% (55/63). Prophylactic anticoagulation with low-molecular-weight heparin (LMWH) was administered in 94% of the clinics. The dosing of LMWH was prophylactic (85%), high prophylactic (adjusted to bodyweight) (7%), or risk adapted (9%). After completion of chemotherapy, anticoagulation was continued in 15 clinics (33%) for 2 to 24 weeks, while the remainder stopped the LMWH upon cessation of chemotherapy. Chemotherapy was administered via central venous access in 59%, peripheral IV in 27%, or both in 14% of the clinics. CONCLUSIONS: Most of the institutions performed some form of thromboprophylaxis, although the modes of application varied by institution type and amongst the urologists and oncologists. Prospective studies are needed to evaluate the incidence, date of occurrence, and risk factors of venous thrombosis during TC chemotherapy to provide a recommendation concerning prophylactic anticoagulation.
Authors: S Lubberts; H Boer; R Altena; C Meijer; A M van Roon; N Zwart; S F Oosting; P W Kamphuisen; J Nuver; A J Smit; A B Mulder; J D Lefrandt; J A Gietema Journal: Eur J Cancer Date: 2016-06-17 Impact factor: 9.162
Authors: Thomas Worst; Lisa Sautter; Axel John; Christel Weiss; Axel Häcker; Julia Heinzelbecker Journal: Urol Int Date: 2015-12-18 Impact factor: 2.089
Authors: Friedemann Honecker; Daniel Koychev; Anna D Luhmann; Florian Langer; Klaus-Peter Dieckmann; Carsten Bokemeyer; Karin Oechsle Journal: Onkologie Date: 2013-10-14
Authors: L Solari; M Krönig; G Ihorst; K Drognitz; J Heinz; C A Jilg; W Schultze-Seemann; M Engelhardt; Cornelius F Waller Journal: Urol Int Date: 2016-04-14 Impact factor: 2.089
Authors: H Boer; J H Proost; J Nuver; S Bunskoek; J Q Gietema; B M Geubels; R Altena; N Zwart; S F Oosting; J M Vonk; J D Lefrandt; D R A Uges; C Meijer; E G E de Vries; J A Gietema Journal: Ann Oncol Date: 2015-09-07 Impact factor: 32.976
Authors: Ben Tran; Jose M Ruiz-Morales; Enrique Gonzalez-Billalabeitia; Anna Patrikidou; Eitan Amir; Christoph Seidel; Carsten Bokemeyer; Christian Fankhauser; Thomas Hermanns; Alexey Rumyantsev; Alexey Tryakin; Margarida Brito; Aude Fléchon; Edmond Michael Kwan; Tina Cheng; Daniel Castellano; Xavier Garcia Del Muro; Anis A Hamid; Margaret Ottaviano; Giovannella Palmieri; Robert Kitson; Alison Reid; Daniel Y C Heng; Philippe L Bedard Journal: Cancer Med Date: 2019-11-12 Impact factor: 4.452