NATURE AND OUTCOME OF FEBRILE EPISODES IN PATIENTS WITH PANCREATIC AND HEPATOBILIARY CANCER

Fifty febrile episodes in patients with hepatobiliary and pancreatic c ancer were reviewed. Biliary obstruction often resulting in cholangiti s was an important predisposing factor, whereas neutropenia ( < 500 PM N/mm(3)) was uncommon (10%). Microbiologically documented infections o riginating from the gastrointestinal tract were predominant, with Ente rococcus faecalis and Escherichia coli being isolated most often. Non- infectious causes of fever occurred in 16% of patients. Only one patie nt developed a fungal infection. The overall response rate to therapy was 94%, with 32% being eligible for outpatient management. These data are quite different from those generated from patients with hematolog ic malignancies and indicate that disease-site specific management gui delines need to be developed for febrile episodes in patients with var ious underlying neoplasms.