Chemotherapy within 30 days before surgery does not augment postoperative mortality and morbidity
Alparslan Turan1, Diana Shao, Vafi Salmasi
1Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77, Cleveland, OH 44195, USA. alparslanturan@yahoo.com
Summary
Neoadjuvant chemotherapy, given before cancer surgery, did not increase early postoperative mortality or major complications in a large patient study. This finding suggests preoperative chemotherapy is safe regarding short-term surgical outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Clinical Research
Background:
- Preoperative chemotherapy is used to reduce tumor size and metastasis risk.
- Chemotherapy can cause side effects impacting the perioperative period.
- The study investigated the impact of recent chemotherapy on surgical outcomes.
Purpose of the Study:
- To determine if chemotherapy within 30 days of cancer surgery increases mortality.
- To assess if preoperative chemotherapy is linked to major postoperative morbidities.
Main Methods:
- Analysis of 971,455 patients from the ACS NSQIP database.
- Matched 1,348 pairs of patients who received chemotherapy within 30 days of surgery and those who did not.
- Logistic regression analysis to compare outcomes between groups.
Main Results:
- Mortality rates were 1.6% in non-chemotherapy patients and 2.2% in chemotherapy patients (P=0.19).
- No statistically significant difference in mortality was found between the groups (OR=1.47).
- Rates of major morbidities, including wound infections, were similar between groups (P=0.09).
Conclusions:
- Preoperative neoadjuvant chemotherapy is not associated with increased early postoperative complications.
- The study found no significant increase in mortality for patients receiving chemotherapy before surgery.
- These findings support the safety of neoadjuvant chemotherapy in relation to short-term surgical outcomes.
Related Concept Videos
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
02:49Cancer Therapies
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates these...