Current Management of Surgical Oncologic Emergencies
Identifieur interne : 001F45 ( Main/Exploration ); précédent : 001F44; suivant : 001F46Current Management of Surgical Oncologic Emergencies
Auteurs : Marianne R. F. Bosscher ; Barbara L. Van Leeuwen ; Harald J. HoekstraSource :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.
A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.
In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.
In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.
Url:
DOI: 10.1371/journal.pone.0124641
PubMed: 25933135
PubMed Central: 4416749
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Current Management of Surgical Oncologic Emergencies</title><author><name sortKey="Bosscher, Marianne R F" sort="Bosscher, Marianne R F" uniqKey="Bosscher M" first="Marianne R. F." last="Bosscher">Marianne R. F. Bosscher</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Van Leeuwen, Barbara L" sort="Van Leeuwen, Barbara L" uniqKey="Van Leeuwen B" first="Barbara L." last="Van Leeuwen">Barbara L. Van Leeuwen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25933135</idno><idno type="pmc">4416749</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416749</idno><idno type="RBID">PMC:4416749</idno><idno type="doi">10.1371/journal.pone.0124641</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000424</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000424</idno><idno type="wicri:Area/Pmc/Curation">000424</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000424</idno><idno type="wicri:Area/Pmc/Checkpoint">001371</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001371</idno><idno type="wicri:Area/Ncbi/Merge">007329</idno><idno type="wicri:Area/Ncbi/Curation">007329</idno><idno type="wicri:Area/Ncbi/Checkpoint">007329</idno><idno type="wicri:Area/Main/Merge">001F48</idno><idno type="wicri:Area/Main/Curation">001F45</idno><idno type="wicri:Area/Main/Exploration">001F45</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Current Management of Surgical Oncologic Emergencies</title><author><name sortKey="Bosscher, Marianne R F" sort="Bosscher, Marianne R F" uniqKey="Bosscher M" first="Marianne R. F." last="Bosscher">Marianne R. F. Bosscher</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Van Leeuwen, Barbara L" sort="Van Leeuwen, Barbara L" uniqKey="Van Leeuwen B" first="Barbara L." last="Van Leeuwen">Barbara L. Van Leeuwen</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author><author><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><affiliation><nlm:aff id="aff001"></nlm:aff></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objectives</title><p>For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.</p></sec><sec id="sec002"><title>Method</title><p>A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.</p></sec><sec id="sec003"><title>Results</title><p>In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.</p></sec><sec id="sec004"><title>Conclusion</title><p>In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cervantes, A" uniqKey="Cervantes A">A Cervantes</name></author><author><name sortKey="Chirivella, I" uniqKey="Chirivella I">I Chirivella</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Katabathina, Vs" uniqKey="Katabathina V">VS Katabathina</name></author><author><name sortKey="Restrepo, Cs" uniqKey="Restrepo C">CS Restrepo</name></author><author><name sortKey="Betancourt, Cuellar Sl" uniqKey="Betancourt C">Cuellar SL Betancourt</name></author><author><name sortKey="Riascos, Rf" uniqKey="Riascos R">RF Riascos</name></author><author><name sortKey="Menias, Co" uniqKey="Menias C">CO Menias</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barbera, L" 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Goossens</name></author><author><name sortKey="Bossuyt, Pm" uniqKey="Bossuyt P">PM Bossuyt</name></author><author><name sortKey="Ubbink, Dt" uniqKey="Ubbink D">DT Ubbink</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Bosscher, Marianne R F" sort="Bosscher, Marianne R F" uniqKey="Bosscher M" first="Marianne R. F." last="Bosscher">Marianne R. F. Bosscher</name><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><name sortKey="Van Leeuwen, Barbara L" sort="Van Leeuwen, Barbara L" uniqKey="Van Leeuwen B" first="Barbara L." last="Van Leeuwen">Barbara L. Van Leeuwen</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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