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01-04-2020 | Wound Infection | Original Scientific Report

Perioperative Outcomes of Melanoma Patients Undergoing Surgery After Receiving Immunotherapy or Targeted Therapy

Authors: James Sun, Dennis A. Kirichenko, Joyce L. Chung, Michael J. Carr, Zeynep Eroglu, Nikhil I. Khushalani, Joseph Markowitz, Jane L. Messina, Vernon K. Sondak, Jonathan S. Zager, Sephalie Y. Patel

Published in: World Journal of Surgery | Issue 4/2020

Abstract

Background

Traditional chemotherapy agents adversely affect wound healing and need to be held prior to or after surgery. Immune checkpoint inhibitors (ICIs) and targeted agents are now standard of care for the several treatment cancers. We hypothesize that ICI and targeted therapy do not have similar adverse effects on perioperative outcomes.

Methods

We performed a review of melanoma patients undergoing surgery at an academic hospital between 2011 and 2019. All patients received ICI or targeted therapy ≤ 60 days prior to surgery, including palliative procedures. Preoperative performance status was assessed using Eastern Cooperative Oncology Group score and American Society of Anesthesiologists Classification System. Thirty-day complications were classified by Clavien–Dindo grade. No statistical comparisons were performed.

Results

Of 63 patients included in the analysis, 29 (46%) patients received ICI and 34 (54%) received targeted therapy with median of 14 days (IQR 5–27 days) between the last preoperative dose and day of surgery (ICI, median 18 days [IQR 13–34.5]; targeted therapy, median 7 days [IQR 3–22.25]). There were no perioperative mortalities. Among patients treated with ICI, 22 patients (76%) had no complications. Four patients had wound infections (2 readmitted), 1 had reoperation (hematoma) and 2 readmitted for other reasons (fever; volvulus). Among patients treated with targeted therapy, 25 patients (74%) had no complications. Seven patients had wound infections (none readmitted), 1 had reoperation (flap failure) and 1 had dehiscence (not treated).

Conclusions

Patients undergoing treatment with ICI or targeted therapies can safely undergo surgery without substantially increased risk of serious intraoperative and postoperative complications.

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Title: Perioperative Outcomes of Melanoma Patients Undergoing Surgery After Receiving Immunotherapy or Targeted Therapy
Authors: James Sun
Dennis A. Kirichenko
Joyce L. Chung
Michael J. Carr
Zeynep Eroglu
Nikhil I. Khushalani
Joseph Markowitz
Jane L. Messina
Vernon K. Sondak
Jonathan S. Zager
Sephalie Y. Patel
Publication date: 01-04-2020
Publisher: Springer International Publishing
Keywords: Wound Infection
Melanoma
Melanoma
Targeted Therapy
Lymphadenectomy
Published in: World Journal of Surgery / Issue 4/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05314-2

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Springer Medicine

Perioperative Outcomes of Melanoma Patients Undergoing Surgery After Receiving Immunotherapy or Targeted Therapy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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