Technical Editor
ISSN 0019-509X
Dr. Prakash C. Gupta
Indian
Journal
Indian Journal of Cancer • Volume 51 • Issue 4 • October - December 2014 • Pages 000 - 000
of
CANCER Volume 51
Issue 4
October - December 2014
Primary gastrointestinal lymphomas - 81 Cases
Predicting ‘time to distant metastasis’ in head and neck cancer
Reproductive risk and breast cancer
Dendritic cell vaccine for CRC and Renal Transplant
Official Publication of
The Indian Cancer Society, The Indian Society of Oncology and Indian Co-operative Oncology Network
Kumar, et al.: MASCC score‑ feasibility and safety 10. Uys A, Rapoport BL, Anderson R. Febrile neutropenia: A prospective study to validate the Multinational Association of Supportive care of Cancer (MASCC) risk‑index score. Support Care Cancer 2004;8:556‑60. 11. Paesmans M, Rapoport B, Maertens J, Slabbeer C, Ferrant A, Wingard J, et al. Multicentric prospective validation of the MASCC risk‑index score for identification of febrile neutropenic cancer patients at low‑risk for serious medical complications. Proc Am Soc Clin Oncol 2000;22:22-35. 12. Klastersky J, Paesmans M, Georgala A, Muanza F, Plehiers B, Dubreucq L, et al. Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. J Clin Oncol 2006;24:4129‑34. 13. Marshall E, Smith DB, O’Reilly SM, Murray A, Kelly V, Clark PI. Low‑dose continuous‑infusion ceftazidime monotherapy in low‑risk febrile neutropenic patients. Support Care Cancer 2000;8:198‑202. 14. Talcott JA, Siegel RD, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: A prospective, two‑center validation of a prediction rule. J Clin Oncol 1992;10:316‑32. 15. Klastersky J, Ameye L, Maertens J, Georgala A, Muanza F, Aoun M, et al. Bacteraemia in febrile neutropenic cancer patients. Int J Antimicrob Agents 2007;30:S51‑9. 16. Viscoli C, Castagnola E. Treatment of febrile neutropenia: What is new. Curr Opin Infect Dis 2002;15:377‑82. 17. Yadegarynia D, Tarrand J, Raad I, Rolston K. Current spectrum of bacterial infections in patients with cancer. Clin Infec Dis 2003;37:1144‑5. 18. Cengiz O, Kucer B, Sürmeli S, Santicky MJ, Soran A. Are pretreatment
19. 20. 21.
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serum albumin and cholesterol levels prognostic tools in patients with colorectal carcinoma. Med Sci Monit 2006;12:CR240‑7. Alici S, Kaya S, Izmirli M. Analysis of survival factors in patients with advanced stage gastric adenocarcinoma. Med Sci Monit 2006;12:CR221‑9. Chen HP, Chen TL, Lai CJ, Fung CP, Wong WW, Yu KW, et al. Predictors of mortality in Acinetobacter baumanii bacteremia. J Microbial Immunol Infect 2005;38:127‑36. Lai C H, Chi CY, Chen HP, Chen TL, Lai CJ, Fung CP, et al. Clinical characteristics and prognostic factors for patients with Stenotrophomonas maltophilia bacteremia. J Microbial Immunol Infect 2004;37:350‑8. Klastersky J, Paesmans M, Rubenstein EB. The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low‑risk febrile neutropenic cancer patients. J Clin Oncol 2000;18:3038‑51. How to cite this article: Kumar P, Bajpai J, Shetty N, Medekar A, Kurkure PA, Ghadyalpatil N, et al. Management of febrile neutropenia in malignancy using the MASCC score and other factors: Feasibility and safety in routine clinical practice. Indian J Cancer 2014;51:491-5. Source of Support: Nil. Conflict of Interest: None declared.
Letter to the Editor Multidisciplinary team meetings for optimal management of cancer patients: A must? Sir, We would like to draw the attention of the oncological fraternity to the established, but minimally practiced concept of multidisciplinary team meetings (MDTs). MDTs in cancer hospitals or tumour boards are a group of dedicated personnel aimed at optimizing the management of cancer patients in an integrated manner. They are necessary in order to standardize cancer care, to ensure timely and appropriate attention from skilled professionals as well as to enable patients to receive the best levels of management in a consistent manner.[1] The team usually comprises of surgeons, oncologists, radiologists, pathologists, nurses and an MDT co‑ordinator.[2] Lamb et al. in the only prospective study to quantify the efficacy of MDT meetings, until date, attempted to assess MDT related variables such as the quality of presented information, case positioning, timing, team size, member’s contribution to discussion as well as the ability to reach clinical decisions. They concluded that accurately presented case histories formed the backbone for discussion, maximal contribution to the discussion was from the surgeon and cases presented early were discussed in a more detailed manner with higher attendance among the group. Thus, this study laid the foundation for structuring of MDTs.
Further points of interest remain the frequency of these MDT sessions, the clinical background of the attendees, the accurate structuring of these meetings as well as assessment of their cost‑effectiveness and logistic issues in their maintenance. A novel concept in this regard is the virtual MDT,[4] which still needs further supportive evidence to overhaul the traditional “in attendance” concept of MDTs.[4] However, in the present scenario, until further evidence emanates against them, it can be safely said that the “face‑to‑face” MDTs remain mandatory, especially in the clinical setting for optimal oncology care. Aggarwal G, Roy MK Department of Surgical Oncology (GI Surgery), Tata Medical Center, New Town, Kolkata, West Bengal, India Correspondence to:
Dr. Gaurav Aggarwal, E‑mail:
[email protected]
[2]
Ke et al.[3] attempted to assess the cost effectiveness of these MDT meetings vis‑à‑vis cancer and non‑cancer care. They however failed to conclude on the same due to lack of evidence as well as a high degree of bias.[3] Nevertheless, the importance of structured MDT meetings especially in the domain of cancer therapy cannot be over emphasized. MDTs provide a forum for shared decision making, in particular for complex cases, where the entire onus of the decision doesn’t lie with the surgeon alone and a holistic approach to a patient’s management is attainable. Indian Journal of Cancer | October–December 2014 | Volume 51 | Issue 4
References 1. 2. 3. 4.
Taylor C, Munro AJ, Glynne‑Jones R, Griffith C, Trevatt P, Richards M, et al. Multidisciplinary team working in cancer: What is the evidence? BMJ 2010;340:c951. Lamb BW, Sevdalis N, Benn J, Vincent C, Green JS. Multidisciplinary cancer team meeting structure and treatment decisions: A prospective correlational study. Ann Surg Oncol 2013;20:715‑22. Ke KM, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost‑effective? A systematic review of the literature. Cost Eff Resour Alloc 2013;11:7. sMunro AJ, Swartzman S. What is a virtual multidisciplinary team (vMDT)? Br J Cancer 2013;108:2433‑41. Access this article online Quick Response Code:
Website: www.indianjcancer.com DOI: 10.4103/0019-509X.175337 PMID: *******
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