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Does starting chemotherapy impact post-biopsy surgical healing?

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The early initiation of chemotherapy after biopsy appears to be an acceptable option, according to the results of a study that aimed to determine the relationship between chemotherapy timing and postoperative surgical complications.

In this retrospective review of 43 patients with malignant solid tumors (neuroblastoma, hepatoblastoma, Ewing sarcoma, germ cell tumor, angiosarcoma, clear cell sarcoma, ganglioneuroblastoma, rhabdoid tumor, and rhabdomyosarcoma) who underwent chemotherapy after surgical biopsy

Patients underwent operative procedures including thoracoscopy (n = 5), laparotomy (n = 17), laparoscopy (n = 14), and superficial (n = 7).

Patients waited a median of 4 days (range: 0-21 days) after biopsy before beginning chemotherapy. There were no noted surgical complications before the initiation of chemotherapy. Two patients (4.7%) experienced surgical complications after starting chemotherapy, including 1 how had postoperative hemorrhage (grade 3) and had started chemotherapy 1 day after biopsy and 1 who had surgical site infection (grade 1) and had started chemotherapy 6 days after biopsy. The complications occurred 10 and 23 days after biopsy, respectively.

The authors concluded that starting chemotherapy early after undergoing biopsy was an acceptable option “particularly in children with bulky or symptomatic malignant solid tumors.”

Hayashi K, Mori M, Sanmoto Y, et al. Relationship between the timing of chemotherapy and surgical complications following surgical biopsy in children with malignant solid tumors. Pediatr Blood Cancer. 2022;e30030. doi: 10.1002/pbc.30030. Epub ahead of print. PMID: 36184783.