Risk of Thromboembolic Events after Perioperative Chemotherapy Versus Surgery Alone for Esophageal Adenocarcinoma.
Summary of "Risk of Thromboembolic Events after Perioperative Chemotherapy Versus Surgery Alone for Esophageal Adenocarcinoma."
BACKGROUND:
Major oncologic surgery is associated with a high incidence of thromboembolic events (TEE). Addition of perioperative chemotherapy in esophageal cancer surgery may increase the risk of TEE.
METHODS:
The thromboembolic toxicity profile was analyzed in patients with esophageal adenocarcinoma (EAC). Two groups were identified: patients who underwent esophagectomy and received perioperative chemotherapy with epirubicin, cisplatin, and capecitabine (ECC; n = 52), and patients who were treated with surgery alone (n = 35).
RESULTS:
A total of 22 TEEs was observed in 17 patients (32.7%) in the chemotherapy group and 3 patients (7.5%) in the surgery-alone group (P < .01). The relative risk of developing a TEE for patients receiving perioperative chemotherapy during the whole treatment period was 3.8 (95% confidence interval 1.2-12.0). A preoperatively occurring TEE did not increase the risk of postoperative TEE, nor did it increase postoperative hospital stay (P = .325). Median postoperative hospital stay was 23 days (range 14-78) for patients with a postoperative TEE and 15 days (range 10-105) for patients without TEE (P = .126). Perioperative chemotherapy with the epirubicin, cisplatin, and capecitabine regimen was independently associated with the development of TEE in the combined preoperative and postoperative period (P = .034).
CONCLUSIONS:
Perioperative chemotherapy improves survival for operable esophageal cancer but comes at the price of toxicity. Perioperative chemotherapy for EAC increases the risk of TEE. However, chemotherapy-related preoperative TEE did not increase the risk of postoperative TEE, nor did it increase postoperative hospital stay, justifying its use in clinical practice.
Affiliation
Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands, R.J.J.Verhage@umcutrecht.nl.
Journal Details
This article was published in the following journal.
Name: Annals of surgical oncology
ISSN: 1534-4681
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21837523
- DOI: http://dx.doi.org/10.1245/s10434-011-2005-8
Medical and Biotech [MESH] Definitions
Second-look Surgery
A followup operation to examine the outcome of the previous surgery and other treatments, such as chemotherapy or radiation therapy.
Perioperative Nursing
Nursing care of the surgical patient before, during, and after surgery.
Perioperative Care
Interventions to provide care prior to, during, and immediately after surgery.
Chemotherapy, Adjuvant
Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Surgical Procedures, Elective
Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.
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