N Laplace1,2, V Kepenekian1,2, A Friggeri3,4, O Vassal3,4, F Ranchon2,5, C Rioufol2,5, W Gertych2,6, L Villeneuve2,7, O Glehen1,2, N Bakrin1,2. 1. Department of Surgical Oncology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France. 2. EMR 3738, Faculte de Medecine et de Maieutique Lyon-Sud Charles Merieux,, Lyon 1 University, Lyon, France. 3. Department of Anaesthesiology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France. 4. UMR CNRS 5308, Inserm U1111, Claude Bernard University, Lyon 1, Lyon, France. 5. Department of Pharmacology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France. 6. Department of Gynecology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France. 7. Service de Recherche et Epidémiologie Cliniques, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France.
Abstract
BACKGROUND: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to provide benefits in the management of peritoneal metastasis. Cisplatin (CDDP) is one of the most frequently used drugs for peritoneal infusion. A major restriction is that CDDP causes renal toxicity and acute renal failure, sometimes leading to chronic renal failure. The aim of the present study was to assess the impact of sodium thiosulfate (ST) in preventing renal impairment (RI) following HIPEC with CDDP. METHODS: This prospective study assessed the RI rates for all patients who underwent HIPEC with CDDP during two successive periods: without ST (nST Period; from November 2016 to September 2017) and with ST (ST Period; from October 2017 to March 2018). During the ST Period, patients received an ST infusion at 9 mg/m2 prior to HIPEC and at 12 mg/m2 at the end of the procedure. RI was defined by postoperative serum creatinine >1.6 times elevation of baseline value. The impact of ST treatment was evaluated by comparison of the RI rates between the two periods. RESULTS: During ST Period, none of 38 patients (0%) developed RI versus 11/35 patients (31.4%) during the nST Period (p < .005); 2 of whom required definitive hemodialysis. Baseline characteristics, background circumstances, indications and laboratory parameters before HIPEC were comparable between the two groups, as well as CDDP dose use during HIPEC. CONCLUSION: ST appears to be an effective drug for the prevention of the renal toxicity of CDDP used for HIPEC and should be used for all such procedures.
BACKGROUND: Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to provide benefits in the management of peritoneal metastasis. Cisplatin (CDDP) is one of the most frequently used drugs for peritoneal infusion. A major restriction is that CDDP causes renal toxicity and acute renal failure, sometimes leading to chronic renal failure. The aim of the present study was to assess the impact of sodium thiosulfate (ST) in preventing renal impairment (RI) following HIPEC with CDDP. METHODS: This prospective study assessed the RI rates for all patients who underwent HIPEC with CDDP during two successive periods: without ST (nST Period; from November 2016 to September 2017) and with ST (ST Period; from October 2017 to March 2018). During the ST Period, patients received an ST infusion at 9 mg/m2 prior to HIPEC and at 12 mg/m2 at the end of the procedure. RI was defined by postoperative serum creatinine >1.6 times elevation of baseline value. The impact of ST treatment was evaluated by comparison of the RI rates between the two periods. RESULTS: During ST Period, none of 38 patients (0%) developed RI versus 11/35 patients (31.4%) during the nST Period (p < .005); 2 of whom required definitive hemodialysis. Baseline characteristics, background circumstances, indications and laboratory parameters before HIPEC were comparable between the two groups, as well as CDDP dose use during HIPEC. CONCLUSION:ST appears to be an effective drug for the prevention of the renal toxicity of CDDP used for HIPEC and should be used for all such procedures.
Authors: Annika Kurreck; Felix Gronau; Miguel Enrique Alberto Vilchez; Wiltrud Abels; Philipp Enghard; Andreas Brandl; Roland Francis; Bettina Föhre; Christian Lojewski; Johann Pratschke; Peter Thuss-Patience; Dominik Modest; Beate Rau; Linda Feldbrügge Journal: Ann Surg Oncol Date: 2021-08-04 Impact factor: 5.344