Thromboembolic disease in testicular germ cell tumors-real-world evidence of three Portuguese institutions

INTRODUCTION: Testicular germ cell tumors (TGCTs) are highly curable malignancies with long-term overall survival (OS) exceeding 90%. Thromboembolic (TE) events are a relevant treatment-related complication, reported in approximately 10% of patients. This study aimed to evaluate the incidence, risk factors, and prognostic impact of TE in TGCT. METHODS: We performed a retrospective multicenter cohort study including 136 post-pubertal male patients with histologically confirmed TGCT treated between 2007 and 2021 at three Portuguese centers. The primary endpoint was to characterize the population of TGCT patients with TE. Secondary endpoints included TE incidence and its impact on OS and progression-free survival (PFS). Identification of clinical, pathological, and treatment-related factors associated with increased TE risk was an exploratory endpoint. RESULTS: Seven patients (5.1%) developed a TE event, all in advanced/recurrent disease (14.6% in this subgroup). No TE occurred in stage I patients, including those treated with adjuvant chemotherapy. Visceral metastases (pulmonary and extra-pulmonary) and poor IGCCCG prognosis were associated with TE (p < 0.05). All TE patients had a central venous catheter (CVC), although only two had catheter-related thrombosis (p = 0.019). For advanced stages, survival outcomes did not differ significantly, with 5-year OS of 71.4% vs. 86.2% (p = 0.22) and PFS of 47.6% vs. 75.5% (p = 0.23) in TE versus non-TE groups, respectively. Most events (86%) occurred within 30 days of chemotherapy initiation, with pulmonary embolism as the most frequent presentation. Neither the Khorana nor the ONKOTEV scores predicted TE. DISCUSSION: TE in TGCT occurred only in patients with advanced disease, was linked to tumor burden and CVC use, and was not predicted by current models. These findings highlight the need for TGCT-specific risk tools and prospective studies on risk-adapted prophylaxis.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Testicular germ cell tumors (TGCTs) are highly curable malignancies with long-term overall survival (OS) exceeding 90%. Thromboembolic (TE) events are a relevant treatment-related complication, reported in approximately 10% of patients.

Explore how this research connects to clinical practice

More peer-reviewed studies in Clinical Trials.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →