Thromoembolische Komplikationen und Thromboseprophylaye bei fortgeschrittenen testikularen Keimzelltumoren

Background Testicular germ cell tumours (TGCT) represent the most common solid neoplasms in young men. Due to the high chemosensitivity, excellent cure rates can be achieved even in metastatic stages. However, thromboembolic complications represent a common event which can impair excellent cure rates in this group of patients. Objectives This article provides a literature review on incidence, location, implications as well as risk factors for the development of venous thromboembolic complications in TCGT patients receiving cisplatin-based chemotherapy and gives an overview on prophylactic anticoagulation. Materials and methods A literature search in PubMed was performed. Results Treatment-associated venous thromboembolic complications occur in up to 19% of all TGCT patients receiving cisplatin-based chemotherapy, most commonly as a pulmonary embolism or deep venous thrombosis. As a result, thromboembolic complications can lead to a reduced overall survival in these patients. Large tumor masses, elevated LDH, endothelial dysfunction and a central venous access were identified as risk factors for the development of venous thromboembolic complications. Current international guidelines remain vague and recommend the use of thromboprophylaxis in high-risk patients. Conclusions TGCT patients undergoing cisplatin-based chemotherapy are at high risk for the development of venous thromboembolic complications, potentially leading to a higher treatment morbidity. Further studies are needed to determine appropriate risk stratification for these patients.