ABSTRACT
OBJECTIVE: To evaluate the difference between early and delayed removal of indwelling urinary catheter after radical hysterectomy (RH) or radical trachelectomy (RT). METHODS: An ambispective study was conducted in early-stage cervical cancer patients who underwent RH or RT. Delayed indwelling urinary catheter removal occurred on a postoperative day (POD) 7 in the retrospective group (January 2012-November 2013), and early removal occurred on POD 1 in the prospective group (May 2014-June 2017). The postvoid residual (PVR) test was performed after indwelling catheter removal in both groups. RESULTS: Our sample included 47 patients in the delayed group and 48 in the early one. There was no difference in age, body mass index, tumor size, histology, stage, surgical approach, and intraoperative and postoperative complications. Indwelling urinary catheter reinsertion was needed in 16 (34%) patients in the delayed group and 12 (25%) in the early group (P = .37), with no statistical difference between the median PVR volumes -82.5 and 45 mL (P = .06), respectively. Seven (14.9%) patients in the delayed group presented with 30-day urinary tract infection vs two (4.2%) in the early group (P = .09). CONCLUSIONS: Early indwelling urinary catheter removal, in regard to the rate of catheter reinsertion and PVR volume, does not differ from delayed removal.
Subject(s)
Catheters, Indwelling , Device Removal , Urinary Catheters , Uterine Cervical Neoplasms/surgery , Adult , Aged , Cohort Studies , Female , Humans , Hysterectomy , Middle Aged , Neoplasm Staging , Postoperative Complications/etiology , Retrospective Studies , Uterine Cervical Neoplasms/pathologyABSTRACT
PURPOSE OF REVIEW: After multimodal treatment, 50-60% of patients with locally advanced squamous cell carcinoma of the head and neck will present locoregional and/or distant relapse within 2 years. This article will review chemotherapy and/or targeted agents as treatment options for patients who progress after platinum-based chemotherapy. RECENT FINDINGS: After years when the only therapeutic option was palliative chemotherapy, monoclonal antibodies targeting the epidermal growth factor receptor have emerged as new treatments. In particular, cetuximab and panitumumab have demonstrated progression-free survival and/or overall survival benefits in the first-line palliative treatment when given in combination with platinum-based chemotherapy. Recently, second-generation compounds (zalutumumab) or irreversible pan-human epidermal receptor (pan-HER) inhibitors have also shown promising activity after platinum failure. SUMMARY: Because median overall survival after platinum failure is less than 1 year, there is a clear requirement for new phase II/III studies with agents that have the potential to improve overall survival and quality of life. The previous use of platinum-based chemotherapy and the type of tumor response observed may substantially impact prognosis. Therefore, prior platinum use should be clearly defined in future clinical trials to enable a more accurate interpretation of the data.