| مستخلص: |
BACKGROUND: Certain oral chemotherapy medications are associated with increased risks for bleeding and wound-healing complications, which necessitates that these drugs be held in the period before and after surgery. The data for holding these oral oncolytic agents are limited, with available evidence focused on major surgeries. OBJECTIVES: To evaluate the hold time and restart parameters at our health system; a key secondary end point was to evaluate the rates of bleeding and wound-healing complications in patients having minor surgery for whom oral oncolytic agents were or were not held. METHODS: This retrospective, single-center cohort study compared the rates of bleeding and wound-healing complications in patients at Geisinger undergoing minor surgical procedures whose oral chemotherapy was held with those whose oral chemotherapy was not held between August 1, 2013, and July 31, 2018. We included patients with cancer who were receiving an oral oncolytic agent that is known to cause bleeding and who had a minor surgical procedure. We excluded patients with cancer who met only 1 of these 2 criteria. RESULTS: A total of 240 patients were included in the analysis, including 183 patients whose oral chemotherapy was held and 57 patients whose oral chemotherapy was not held. The baseline characteristics of the patients were similar between the groups, although more patients with breast cancer stopped receiving chemotherapy versus those who did not stop receiving chemotherapy (9.8% vs 2%, respectively; P=.048). In patients whose chemotherapy was held, 34.4% received hydroxyurea compared with 65% in those whose chemotherapy was not held (P<.003). No differences were noted in bleeding or wound dehiscence between the cohorts that did and did not stop receiving oral chemotherapy (1.7% vs 5.3%, respectively; P=.126). All 3 occurrences of bleeding or wound complications were in patients who received hydroxyurea in the cohort in which oral chemotherapy was held. In the cohort of patients in which oral chemotherapy was not held, there was 1 case of wound complication each associated with regorafenib, everolimus, and ibrutinib treatments. In the cohort whose oral chemotherapy was held, the median time that the medication was held before and after the surgical procedure was 6 and 5 days, respectively. CONCLUSION: This study showed that, for procedures associated with a minor bleeding risk, the rates of bleeding and wound-healing complications are low. The rates of these complications did not differ based on whether a patient's medication was held or not held before and after the surgical procedure. If oral chemotherapy is going to be held before and after surgery, an average hold of 5 days is safe. [ABSTRACT FROM AUTHOR] |
