{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:25:49Z","timestamp":1771259149162,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Germ cell tumors are the most common neoplasia in males &lt; 50 y. In two case series, thromboembolic events (TEs) were reported in 8% and 13% of patients undergoing chemotherapy, whereas arterial thromboembolic events (ATEs) in other types of cancer treated with cisplatin had a frequency of 2% in a retrospective series and 0.67% in a meta-analysis. Recent data found a frequency of 2.4% for ATE in a large cohort of testicular cancer patients. Risk factors are not clearly identified, and given the severity of these events, further exploration is needed to determine appropriate preventive measures. Methods: We performed a retrospective cohort study of 171 patients undergoing chemotherapy for germ cell tumors in two centers in Switzerland and recorded the occurrence of ATE or venous thromboembolic events (VTEs) during chemotherapy or in the 3 months after its completion. Results: of 171 patients, 33.3% underwent adjuvant chemotherapy for stage I disease. Overall, 32 patients had a TE (18.7%, 95% CI 13.3\u201325.5%), 26 (15.2%, 95% CI 10.3\u201321.7%) had VTEs, and 11 (6.4%, 95% CI 3.4\u201311.5%) had ATEs. Five patients had both a VTE and ATE. VTEs were associated with disease stage (II, III, or relapse, with OR 15.6, p = 0.0002), retroperitoneal lymph nodes \u2265 3.5 cm (OR 3.2, p = 0.012), LDH &gt; 500 UI\/L (OR 5.3, p = 0.0025), and age &gt; 35 y (OR 3.4, p = 0.005). The Khorana Score (KS) varied between 1 and 2 in 96% of the patients. ATEs were associated with active smoking (OR 6.5 p = 0.010), KS of \u22652 (OR 6.4 p = 0.004), and age &gt; 35 y (OR 6.3, p = 0.01). Conclusions: Our findings show that ATEs are more frequent in our cohort than previous reports. We found a strong association between smoking and ATEs, which should be further assessed. Platinum-induced endothelial damage may be amplified by smoking in young patients in the absence of other risk factors and preventive medication.<\/jats:p>","DOI":"10.3390\/cancers17142370","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T10:33:47Z","timestamp":1752748427000},"page":"2370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors for Arterial Thromboembolic Events in Male Germ Cell Tumors Treated with Chemotherapy"],"prefix":"10.3390","volume":"17","author":[{"given":"Daniele","family":"Frisone","sequence":"first","affiliation":[{"name":"Service d\u2019Oncologie, D\u00e9partement d\u2019Oncologie, H\u00f4pitaux Universitaire de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-2295","authenticated-orcid":false,"given":"Melinda","family":"Charrier","sequence":"additional","affiliation":[{"name":"Service d\u2019Oncologie, D\u00e9partement d\u2019Oncologie, H\u00f4pitaux Universitaire de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gr\u00e9goire","family":"Berthod","sequence":"additional","affiliation":[{"name":"Service d\u2019Oncologie, Centre Hospitalier du Valais Romand, H\u00f4pital du Valais, 1951 Sion, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Manzocchi-Besson","sequence":"additional","affiliation":[{"name":"Service d\u2019Angiologie et H\u00e9mostase, Centre Hospitalier du Valais Romand, H\u00f4pital du Valais, 1951 Sion, Switzerland"},{"name":"Service d\u2019Angiologie et H\u00e9mostase, H\u00f4pitaux Universitaire de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Danzer","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Vasculaire, Centre Hospitalier du Valais Romand, H\u00f4pital du Valais, 1951 Sion, Switzerland"},{"name":"Service de Chirurgie Vasculaire, H\u00f4pitaux Universitaire de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8060-6349","authenticated-orcid":false,"given":"Sandro","family":"Anchisi","sequence":"additional","affiliation":[{"name":"Service d\u2019Oncologie, Centre Hospitalier du Valais Romand, H\u00f4pital du Valais, 1951 Sion, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3613-6682","authenticated-orcid":false,"given":"Petros","family":"Tsantoulis","sequence":"additional","affiliation":[{"name":"Service d\u2019Oncologie, D\u00e9partement d\u2019Oncologie, H\u00f4pitaux Universitaire de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 de Gen\u00e8ve, 1205 Gen\u00e8ve, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","first-page":"I17","article-title":"Venous thromboembolism and cancer","volume":"107","author":"Lee","year":"2003","journal-title":"Risks and outcomes. 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