Guidelines for Complications of Cancer Treatment Vol VIII Part B

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Category 1B: Do not routinely use vancomycin forantimicrobial prophylaxisSurgical Wound Classification 4Class I/Clean: An uninfected operative wound in which noinflammation is encountered and the respiratory, alimentary,genital, or uninfected urinary tract is not entered. In addition,clean wounds are primarily closed and, if necessary, drainedwith closed drainage.Class II/Clean-Contaminated: An operative wound in whichthe respiratory, alimentary, genital or urinary tracts are enteredunder controlled conditions and without unusualcontamination.Class III/Contaminated: Open, fresh, accidental wounds. Inaddition, operations with major breaks in sterile technique (e.g.,open cardiac massage) or gross spillage from thegastrointestinal tract, and incisions in which acute, nonpurulentinflammation is encountered are included in this category.Class IV/Dirty-Infected: Old traumatic wounds with retaineddevitalized tissue and those that involve existing clinicalinfection or perforated viscera. This definition suggests thatthe organisms causing postoperative infection were present inthe operative field before the operation.References1. Horan TC, Gaynes RP, Martone WJ, et al. CDCdefinitions of nosocomial surgical site infections, 1992:a modification of CDC definitions of surgical woundinfections. Infect Control Hosp Epidemiol1992;13(10):606-8.2. Nichols RL. Preventing surgical site infections: asurgeon’s perspective. Emerg Infect Dis2001;7(2):220 4.45
3. Mangram AJ, Horan TC, Pearson ML, et al. Guidelinefor prevention of surgical site infection 1999. InfectControl Hosp Epidemiol 1999;20:247-80.4. Simmons BP. Guideline for prevention of surgical woundinfections. Infect Control 1982;3:185-96.46
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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 and 22: 2. Smoking as a risk factor for wou
Page 23 and 24: 4. Preoperative core needle biopsy
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: RecommendationsA. Preparation of th
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
Page 74 and 75: c. Administer face mask preoxygenat
Page 76 and 77: 5. The use of exhaled carbon dioxid
Page 78 and 79: disorder) may occur after an episod
Page 80 and 81: undergoing general anesthesia, eith
Page 82 and 83: anesthesia awareness occurred in ea
Page 84 and 85: The current guidelines are actually
Page 86 and 87: o S - Strong Recommendation -Commit
Page 88 and 89: oSource control ASAP after successf
Page 90 and 91: oooWean steroids once vasopressors
Page 92 and 93: Mechanical ventilation of sepsis-in
Page 94 and 95: o CVVH offers easier management inh
Page 96 and 97: critically ill patient that are con
Page 98 and 99: Rivers E, Nguyen B, Havstad S, et a
Page 100 and 101: in survival of 7.6%. By the second
Page 102 and 103: parameters (gastric mucosal Pco2, s
Page 104 and 105:
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
Page 244 and 245:
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
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Combination Chemotherapy:Combinatio
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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
Page 486 and 487:
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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