Guidelines for Complications of Cancer Treatment Vol VIII Part B

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smoking is predictive for post-mastectomy wound infection,skin flap necrosis, and epidermolysis.PMID: 12477471 [PubMed - indexed for MEDLINE]3. Wound complications after modified radicalmastectomy compared with tylectomy with axillarylymph node dissection.Vinton AL, Traverso LW, Jolly PC. Am J Surg. 1991May;161(5):584-8.Tylectomy with axillary lymph node dissection andradiotherapy (TAD) has become an accepted treatment forearly breast cancer and has been shown to result in equal 5-and 8-year survival when compared with modified radicalmastectomy (MRM). In order to determine the safety of TADwith respect to wound complications and to identify potentialrisk factors, we reviewed the charts of 560 patients undergoingMRM (n = 387) and TAD (n = 173) at Virginia Mason MedicalCenter from 1983 through 1989. The incidence of infection,seroma, hematoma, and epidermolysis were compared, andobesity, age 60 years or older, smoking, antibiotics, and wounddrainage were examined as possible risk factors. There weremore wound complications in the MRM group versus the TADgroup (49% versus 35%; p less than 0.01), specifically moreseromas (29% versus 18%; p less than 0.01) and epidermolysis(18% versus 0%). In the MRM group, age 60 years or olderwas associated with seroma (p less than 0.01) and smokingwas associated with epidermolysis (p less than 0.01). In theTAD group, obesity was associated with infection. In bothgroups, volume of drainage from closed suction wound drainsgreater than 30 mL in the 24 hours prior to removal of the lastdrain was associated with seroma (p less than 0.05).PMID: 2031542 [PubMed - indexed for MEDLINE]13
4. Preoperative core needle biopsy as an independentrisk factor for wound infection after breast surgery.Witt A, Yavuz D, Walchetseder C. et al. Obstet Gynecol. 2003Apr;101(4):745-50.OBJECTIVE: Diverging findings concerning the rate ofpostoperative wound infections in patients undergoing breastsurgery have been reported, and little is known regarding thepossible risk factors for these infections and their relativeimportance. We assessed risk factors for wound infection,placing particular emphasis on the influence of preoperativeprocedures such as core needle biopsy. METHODS: In aprospective evaluation of 326 patients undergoing breastsurgery, we identified risk factors for wound infections byunivariate analysis and subsequent step-wise multiple logisticregression. Assessment of wound infection was based on asimple wound scoring system. RESULTS: Of the 326 patients,50 (15.3%) developed wound infections. As expected, afterunivariate analysis a higher proportion of post surgicalinfections was observed in patients with diabetes (33.3% versus14.3%; odds ratio [OR] = 3.00, 95% confidence interval [CI]1.109, 8.157; P =.03) and malignant tumors (21.2% versus6.8%; OR = 3.716, 95% CI 1.762, 7.849; P
Page 1 and 2: Guidelines forComplications ofCance
Page 3: Dedicated toAll our patients atThe
Page 6 and 7: Section IIHead & Neck 151Complicati
Page 8 and 9: PrefaceTreatment of cancer by vario
Page 10: Section — IGeneralContributorsDr.
Page 13 and 14: 6. Complications after breast recon
Page 15 and 16: promises to reduce this risk of ser
Page 17 and 18: preceded by increased sensory hyper
Page 19 and 20: had significant lymphoedema. The fa
Page 21: 2. Smoking as a risk factor for wou
Page 25 and 26: eduction mammoplasty, and axillary-
Page 27 and 28: postoperative wound infection follo
Page 29 and 30: ablative surgical treatment for car
Page 31 and 32: postoperative seroma formation usin
Page 33 and 34: dressing consisted of a circumferen
Page 35 and 36: mastectomies with axillary node cle
Page 37 and 38: mastectomy for breast cancer. Early
Page 39 and 40: monitored for the development of po
Page 41 and 42: modality, and tumor stage distribut
Page 43 and 44: 26. Pain and other symptoms during
Page 45 and 46: 28. Coping, catastrophizing and chr
Page 47 and 48: surgical technique at the time of m
Page 49 and 50: 0.001), 0.315 cm +/- 1.27 at the an
Page 51 and 52: or heat and superficial incision is
Page 53 and 54: RecommendationsA. Preparation of th
Page 55 and 56: 3. Mangram AJ, Horan TC, Pearson ML
Page 57 and 58: Mild hypothermia increases blood lo
Page 59 and 60: Perioperative Normothermia to Reduc
Page 61 and 62: Priorities: Restoration of circulat
Page 63 and 64: than 1.5 times control values but f
Page 65 and 66: outcomes that may result from the u
Page 67 and 68: Preoperative Preparation of the Pat
Page 69 and 70: patients, or other patients who may
Page 71 and 72: Obstruction can occur at the level
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c. Administer face mask preoxygenat
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5. The use of exhaled carbon dioxid
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disorder) may occur after an episod
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undergoing general anesthesia, eith
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anesthesia awareness occurred in ea
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The current guidelines are actually
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o S - Strong Recommendation -Commit
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oSource control ASAP after successf
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oooWean steroids once vasopressors
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Mechanical ventilation of sepsis-in
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o CVVH offers easier management inh
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critically ill patient that are con
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Rivers E, Nguyen B, Havstad S, et a
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in survival of 7.6%. By the second
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parameters (gastric mucosal Pco2, s
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syndrome. We therefore conducted a
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Complications After Limb SalvageSur
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local tumor and to preserve as much
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femoral head to the center of the k
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4. Griffin AM, Parsons JA, Davis AM
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20. Roberts P, Chan D, Grimer RJ, e
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An infection can have disastrous co
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and facilitating reimplantation sur
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features of a two-stage revision is
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patients had an amputation. Two oth
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its main role is confined to ruling
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2. Capanna R, Morris HG, Campanacci
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21. Wilson MG, Kelley K, Thornhill
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39. Love C, Marwin SE, Tomas MB, Kr
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5. A systematic review of 25 RCT’
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(cefazolin or cefuroxime) or penici
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should be based on the isolates fro
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such as concomitant use of prophyla
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Surgical techniqueAdherence to meti
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2. Another small prospective random
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Antibiotic prophylaxis for dental a
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Antimicrobial Prophylaxis in Orthop
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35. Tai CC, Nirvani AA, Holmes A, e
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53. Parker MJ, Roberts C. Closed su
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Vessel Related Issues in Sarcoma:Ev
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sequences may be of value. They cau
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an excellent alternative to amputat
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5. Hünerbein M, Hohenberger P, Str
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Oral IncompetenceOral competence is
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flap is insensate and has no motor
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16. R. Song, Y. Gao, Y. Song, Y. Yu
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The incidence is usually lower afte
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Late fibrotic phase: Attempted tiss
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Ref: A Lyons, N Ghazali/ British J
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17. Store G, Boysen M. Mandibular o
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amino acids, proteins and traces of
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RTOG, EORTC and CTCAE, version 3 fo
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difference in the disease related p
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References1. Bourhis J, Rosine D. R
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with head and neck cancer. N Engl J
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MucositisMucositis is an inflammato
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Type of cancer: high risk for mucos
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Oral care protocol1. Brush all toot
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3. El-Sayed S, Nabid A, ShelleyW, e
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1) Recipient site problems- The maj
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estoration of vascular flow to tiss
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General Complications- Deep vein th
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Nerve Injuries(Recurrent and Superi
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paramedian position, it will result
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along with its variations, and a me
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anatomy as related to surgery of th
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Risk factorsCentral compartment (Le
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Goal - To raise serum calcium level
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Pharyngocutaneous Fistula (PC Fistu
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Based on our institutional practice
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fistula: The Memorial University ex
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Risk factors (LOE-5)Patient factors
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oCircumferencial excision and inser
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y trauma or tumor, exposing the und
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Arytenoid cartilage is reported to
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Filntisis, G.A., et al. “Laryngea
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As high as 52% patients are detecte
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ManagementPostural exercisesDisorde
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References1) Objective assessment o
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Diagnosis Average time to hypothyro
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Management of Facial Nerve InjuryIn
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2. Interposition or cable graft (to
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Prevention of corneal exposure Tars
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flushing) and localized sweating (g
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Other options :1. Intracutaneous in
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Shoulder Dysfunction or PainfulShou
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EMG studies on scapulo-humeral and
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Chyle Fistula after Neck Dissection
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Rationale:LCTs, which constitute 70
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CSF Leak after Craniofacial Resecti
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to the muscle to recreate the orbit
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Conservative treatmentIt is logical
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Complications Associated with use o
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Following is the example of hematol
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ooooooo direct interaction with the
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ooooointravenously over 15 minutes
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in most of the patients. The common
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Section — IIIRadiotherapyContribu
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nodes are involved or suspected to
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function. In general, with conventi
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like ultrasonography, CT scan, endo
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catheter passed through the anus in
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Acute symptoms usually subside seve
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granulocytopenia, thrombocytopenia
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adiation therapy), IMRT (intensity-
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patients who have received radical
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ate expected in the standard popula
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adjusting for competing causes of d
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therapy (3D-CRT) and intensity modu
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attributed to use of cisplatin base
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Conclusion:Incidence of SMN is incr
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11. Travis LB, Fossa SD, Schonfeld
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adiation-related solid SMNs will in
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0.71, p
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5.65%) within 45 years after a CNS
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adiation damage though supporting v
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without calcification. Inflammation
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patients treated using the original
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incidence of valvular thickening at
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12. Hancock S, Hoppe R. Long-term c
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syndrome and bronchiolitis oblitera
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Darby SC, McGale P, Taylor CW, Peto
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undertaken, based on individual pat
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Pathophysiological Aspects:The func
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Symptoms: Symptoms related to pulmo
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Prevention of Pneumonitis and Lung
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genotyping analysis of single nucle
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Registry of Patients. We computed I
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eceived elective nodal irradiation
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Int J Radiat Oncol Biol Phys. 1995
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worsening during the treatment shou
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Differential Diagnosis: This sign i
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Dose Incidence Comments Author>30 G
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PET scan findings have been describ
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3. Pallis CA, Louis S, Morgan RL.:
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24. Abbatucci JS, Delozier T, Quint
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and summarized into specific recomm
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adequate. With the increasing use o
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Complications are mainly described
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IQ decline is associated with sever
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activity’ of a person, essentiall
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development after brain tumor thera
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Highest relative risk of second can
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Suggested Reading:A) Neuropsycholog
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aseline. Male sex, longer symptomat
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number of patients. Cognition was p
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16 years, the corresponding value w
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15 of 20 (75%) subjects, endocrine
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OBJECTIVE: To assess cerebrovascula
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hypometabolism. Of the 17 patients
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10-20 months, with an average of 18
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Febrile NeutropeniaNeutropenia is w
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Approach to initial antibiotic use
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Known colonization with Penicillin/
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DocumentedinfectionsSuggesteddurati
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Zygomycosis and other mold infectio
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Overall risk Examples Febrile neutr
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Broad spectrum DOSE Spectrum Commen
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Role of G-CSF-Primary Prophylaxis:R
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Chemotherapy Induced Nausea andVomi
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Level I Level II Level III Level IV
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Types & doses of AntiemeticsDrug &
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supported by a meta-analysis, which
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and follow-up after treatment for n
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day 1; aprepitant and dexamethasone
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2-3: APR 80 mg every day) or a cont
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Late Effects in Childhood CancerSur
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to increase their awareness about l
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Contd...Score2BStatement of consens
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6 Kurkure PA, Achrekar S, Uparkar U
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nonirradiated group did not differ
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Gaslini Children’s Research Hospi
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Our ACT model has 3 basic facets; p
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The relative risk of developing TLS
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the excretion of uric acid and phos
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hyperuricemia (> 7.5 mg/dL), treatm
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hydration, and the administration o
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which the different drugs are admin
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Table 2. Cairo-Bishop clinical Tumo
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Table 4 Patient Stratification by R
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Table 6 Management of Electrolyte A
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of TLS and improve the management o
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4. Efficacy and safety of rasburica
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Pulmonary Toxicity of Antineoplasti
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Though there are many chemotherapeu
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corticosteroids with variable respo
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Nephrotoxicity ofChemotherapeutic D
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associated with use of carbopltin c
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Table 2 Chemotherapeutics Requiring
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against ifosfamide nephrotoxicity.
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The incidence of mucositis involvin
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7. Obesity - Probably due to over d
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conditioning treatment and for 3 da
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References and Recommended Readings
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metabolism for activity, cyclophosp
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delays excretion and eventually res
Page 476 and 477:
Combination Chemotherapy:Combinatio
Page 478 and 479:
Vincristine: No dose reduction if b
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19. Slichenmyer WJ, Rowinsky EK, Gr
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AlopeciaCommon drugs causing alopec
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dependent, occurring from 8 days to
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Cancer Induced Anemia (CIA)Introduc
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system. There is an upregulation of
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time may represent increasing anemi
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(rHuEPO) whiles the other received
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Table 3. Improvements in Hemoglobin
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2. Groopman JE, Itri LM. Chemothera
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epoetin alfa versus oral iron or no
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NOTES
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Guidelines for Complications of Cancer Treatment Vol VIII Part B

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