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Surgical Emergencies in the Cancer Patient pp 31–44Cite as

Surgical Considerations and Emergencies in the Cancer Patient Receiving Immunotherapy

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Abstract

The increasing clinical use of immunotherapies among various malignancies, predominated by immune checkpoint inhibitors, has increased the potential for unique toxicities a practicing surgeon should be aware of. These manifestations are predominated by gastrointestinal toxicities due to immune cell infiltration which mimic autoimmune conditions such as inflammatory bowel disease. Patients may present with diarrhea, gastrointestinal bleeding, and abdominal pain typically managed with immunosuppressive strategies such as high-dose corticosteroids. However, cases refractory to such measures or the rare cases presenting with up-front gastrointestinal perforation require urgent surgical intervention. The goal of this chapter is to provide an overview of immunotherapeutic strategies, with a focus on immune checkpoint inhibitors, and their respective gastrointestinal toxicities reported in the literature, and provide guidelines to assist the practicing surgeon in this rapidly growing field.

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Authors and Affiliations

  1. Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA

    Joseph Chao M.D. & Marwan Fakih M.D.

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  1. Joseph Chao M.D.
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  2. Marwan Fakih M.D.
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Correspondence to Joseph Chao M.D. .

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Editors and Affiliations

  1. Department of Surgery, City of Hope Medical Center, Duarte, California, USA

    Yuman Fong

  2. Department of Surgery, City of Hope Medical Center, Duarte, California, USA

    Rondi Marie Kauffmann

  3. Surgical Oncology Hepatobiliary Surgery, City of Hope Medical Center, Duarte, California, USA

    Emily Marcinkowski

  4. Department of Surgery, City of Hope Medical Center, Durate, California, USA

    Gagandeep Singh

  5. Department of Surgery, City of Hope Medical Center, Duarte, California, USA

    Hans F. Schoellhammer

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Chao, J., Fakih, M. (2017). Surgical Considerations and Emergencies in the Cancer Patient Receiving Immunotherapy. In: Fong, Y., Kauffmann, R., Marcinkowski, E., Singh, G., Schoellhammer, H. (eds) Surgical Emergencies in the Cancer Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-44025-5_3

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  • DOI: https://doi.org/10.1007/978-3-319-44025-5_3

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