Chemotherapy in Patients with Organ Dysfunction

Feasibility and Outcomes of Ureteroureterostomy and Extravesical Ureteroneocystostomy as Part of Radical Surgery for Infiltrating Gynecologic Disease

“…In addition, surgical reconstruction of the urinary tract may maintain renal function, which also is of paramount importance for adjuvant chemotherapy. 15 This also accounts for young women with hydronephrosis due to deep infiltrating endometriosis. Only 3 studies have described elective ureteric resection in gynecologic surgery.…”

Laboratory monitoring in oncology

“…Table 2 lists the drugs that can cause hepatic toxicity. 19,20 A variety of different tests are associated with the liver. They include tests of the liver's synthetic capability, cholestatic and hepatocellular diseases, hepatocellular injury, and viral hepatitis.…”

“…One of the primary difficulties in the evaluation of the appropriate dose and chemotherapy agent is determining an appropriate definition of hepatic insufficiency. 19 Different medical disciplines may evaluate hepatic function differently. Furthermore, there is no agreement on what constitutes hepatic dysfunction in regard to pharmacology.…”

“…Most protocols have defined laboratory values, some based on the liver's synthetic function, and others related to metabolism, or the transaminases. 19 It is generally agreed that a dose modification should be attempted in patients with elevated liver enzymes. Those anticancer drugs with known hepatotoxic effects should be avoided or given at reduced doses in patients with underlying liver dysfunction.…”

“…As a result, limited information is available on the optimal dosage and schedule in patients with organ dysfunction. 19 Over the past decade, there has been a greater effort to focus on chemotherapy in these patients. Still, as most chemotherapeutic drugs are metabolised and excreted by the liver or kidney, and the knowledge of drug elimination remains incomplete, clinicians face a challenge when dealing with renal dysfunction.…”