Patients Undergoing Systemic Anti-Cancer Therapy Who Require Surgical Intervention: What Surgeons Need to Know

Simple Summary As cancer treatment continues to evolve and novel therapeutic agents are introduced, the landscape of associated safety concerns becomes more complex. It is common for patients with cancer to require some level of surgical procedure either as part of their disease management, for emergency treatment or in symptom control. This review aimed to evaluate the available evidence around surgical complications in patients receiving systemic anti-cancer therapy, examine the recommended risk mitigation options and highlight important safety considerations for patients who require surgery whilst receiving cancer treatment. As part of routine cancer care, patients may undergo elective surgery with the aim of long-term cure. Some of these patients will receive systemic anti-cancer therapy (SACT) in the neoadjuvant and adjuvant settings. The majority of patients, usually with locally advanced or metastatic disease, will receive SACT with palliative intent. These treatment options are expanding beyond traditional chemotherapy to include targeted therapies, immunotherapy, hormone therapy, radionuclide therapy and gene therapy. During treatment, some patients will require surgical intervention on an urgent or emergency basis. This narrative review examined the evidence base for SACT-associated surgical risk and the precautions that a surgical team should consider in patients undergoing SACT.

Automated summary

As cancer treatment advances, the safety concerns related to surgical procedures in cancer patients receiving systemic anti-cancer therapy (SACT) become more complex. This review examines the available evidence on surgical complications in these patients, recommends risk mitigation strategies, and highlights important safety considerations for surgery during cancer treatment.