|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 2 | Page : 331-332
Authors' reply to Jiwnani et al.
Nandini Menon, Vanita Noronha, Amit Joshi, Vijay Patil, Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
|Date of Submission||14-May-2020|
|Date of Decision||16-May-2020|
|Date of Acceptance||16-May-2020|
|Date of Web Publication||19-Jun-2020|
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Menon N, Noronha V, Joshi A, Patil V, Prabhash K. Authors' reply to Jiwnani et al. Cancer Res Stat Treat 2020;3:331-2
We agree with Jiwnani et al. that patients with early-stage lung and esophageal cancers have a chance at long-term survival if treated in time, and they need a personalized treatment approach. We also share the concern that the coronavirus disease-2019 (COVID-19) pandemic is causing a delay in the treatment of this potentially curable subset of patients.
In the study by Felip et al., the disease-free survival in patients who underwent upfront surgery for resectable N2 lung cancers followed by adjuvant chemotherapy and those who received neoadjuvant therapy was not significantly different. However, it must be noted that, in this trial, only 66.2% of the patients started the planned adjuvant chemotherapy as compared to 97% of the patients who started neoadjuvant chemotherapy. This must be considered when planning the upfront surgery approach.
As Jiwnani et al. have rightly said, the patient and their caregivers should be involved in the decision-making process from the very first visit. The risk of immunosuppression with neoadjuvant chemotherapy, the potential risk of COVID-19, and the possibility that the patient might not be able to receive adjuvant chemotherapy later need to be discussed at the time of planning the treatment.
We also agree that recording a careful history of symptoms and exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mandatory and preoperative testing should be considered, as these patients could have a higher morbidity and mortality if they have a concomitant SARS-CoV-2 infection at the time of surgery.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Jiwnani S, Niyogi D, Tiwari V. COVID-19 and thoracic cancers: A balancing act. Cancer Res Stat Treat 2020;3:330-1. [Full text]
Menon N, Noronha V, Joshi A, Patil V, Prabhash K. Systemic therapy for thoracic malignancies during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl S1:29-34.
Felip E, Rosell R, Maestre JA, Rodríguez-Paniagua JM, Morán T, Astudillo J, et al.
Preoperative chemotherapy plus surgery versus surgery plus adjuvant chemotherapy versus surgery alone in early-stage non-small-cell lung cancer. J Clin Oncol 2010;28:3138-45.
Prem A, Patel S, Pai E, Pandey D. Surgical management of cancer during the COVID-19 pandemic. Cancer Res Stat Treat 2020;3 Suppl S1:119-22.