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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 2  |  Page : 331-332

Authors' reply to Jiwnani et al.


Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Date of Submission14-May-2020
Date of Decision16-May-2020
Date of Acceptance16-May-2020
Date of Web Publication19-Jun-2020

Correspondence Address:
Nandini Menon
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_195_20

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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

How to cite this URL:
Menon N, Noronha V, Joshi A, Patil V, Prabhash K. Authors' reply to Jiwnani et al. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Jul 12];3:331-2. Available from: http://www.crstonline.com/text.asp?2020/3/2/331/287239



We agree with Jiwnani et al.[1] 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.[2]

In the study by Felip et al.,[3] 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.[1] 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.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jiwnani S, Niyogi D, Tiwari V. COVID-19 and thoracic cancers: A balancing act. Cancer Res Stat Treat 2020;3:330-1.  Back to cited text no. 1
  [Full text]  
2.
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.  Back to cited text no. 2
    
3.
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.  Back to cited text no. 3
    
4.
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.  Back to cited text no. 4
    




 

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