Supplementary Material for: Thromboembolic Events in Patients with Testicular Germ Cell Tumours Are Predominantly Triggered by Advanced Disease and by Central Venous Access Systems

<b><i>Background:</i></b> Thromboembolic events (TEEs) may significantly complicate the clinical management of patients with testicular germ cell tumours (GCTs). We analysed a cohort of GCT patients for the occurrence of TEEs and looked to possible pathogenetic factors. <b><i>Patients, Methods:</i></b> TEEs occurring within 6 months after diagnosis were retrospectively analysed in 317 consecutive patients with testicular GCT (median age 37 years, 198 seminoma, 119 nonseminoma). The following factors were analysed for association with TEE: histology, age, clinical stage (CS), chemotherapy, use of a central venous access device (CVA). Data analysis involved descriptive statistical methods with multivariable analysis to identify independent risk factors. <b><i>Results:</i></b> Twenty-three TEEs (7.3%) were observed, 18 deep vein thromboses, 4 pulmonary embolisms, and 1 myocardial infarction. Univariable risk calculation yielded the following odds ratios (ORs) : &gt;CS1 OR = 43.7 (95% confidence intervals [CIs] 9.9–191.6); chemotherapy OR = 7.8 (95% CI 2.3–26.6); CVA OR = 30.5 (95% CI 11.0–84.3). Multivariable analysis identified only CS &gt; 1 (OR = 16.9; 95% CI 3.5–82.4) and CVA (OR = 9.0; 95% CI 2.9–27.5) as independent risk factors. <b><i>Conclusions:</i></b> Patients with CSs &gt;CS1 are at significantly increased risk of TEEs even without chemotherapy. Particular high risk is associated with the use of CVA devices for chemotherapy. Caregivers of GCT patients must be aware of the particular risk of TEEs.

**背景：** 血栓栓塞事件(Thromboembolic Events, TEEs)可能显著增加睾丸生殖细胞肿瘤(Testicular Germ Cell Tumours, GCTs)患者的临床管理复杂度。本研究针对睾丸生殖细胞肿瘤患者队列中血栓栓塞事件的发生情况展开分析，并探讨潜在致病因素。
**患者与方法：** 本研究回顾性分析了317例连续入组的睾丸生殖细胞肿瘤患者（中位年龄37岁，其中198例为精原细胞瘤(seminoma)，119例为非精原细胞瘤(nonseminoma)）诊断后6个月内发生的血栓栓塞事件。我们分析了以下因素与血栓栓塞事件的相关性：组织学类型、年龄、临床分期(Clinical Stage, CS)、化疗以及中心静脉置管(Central Venous Access Device, CVA)的使用情况。数据分析采用描述性统计方法结合多变量分析，以识别独立危险因素。
**结果：** 本研究共观察到23例血栓栓塞事件（占比7.3%），其中18例为深静脉血栓形成(Deep Vein Thrombosis)，4例为肺栓塞(Pulmonary Embolism)，1例为心肌梗死(Myocardial Infarction)。单因素风险计算得到如下比值比(Odds Ratios, ORs)：临床分期>CS1的OR值为43.7（95%置信区间[Confidence Intervals, CIs] 9.9~191.6）；化疗的OR值为7.8（95%CI 2.3~26.6）；中心静脉置管的OR值为30.5（95%CI 11.0~84.3）。多变量分析显示，仅临床分期>1（OR=16.9；95%CI 3.5~82.4）与中心静脉置管（OR=9.0；95%CI 2.9~27.5）为独立危险因素。
**结论：** 临床分期>CS1的睾丸生殖细胞肿瘤患者即使未接受化疗，血栓栓塞事件的发病风险也显著升高；使用中心静脉置管进行化疗的患者则面临极高的血栓栓塞风险。临床医护人员需警惕睾丸生殖细胞肿瘤患者发生血栓栓塞事件的特殊风险。