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Ye J, Ren Y, Wei Z, Peng J, Chen C, Song W, Tan M, He Y, Yuan Y. Nephrotoxicity and long-term survival investigations for patients with peritoneal carcinomatosis using hyperthermic intraperitoneal chemotherapy with cisplatin: A retrospective cohort study. Surg Oncol 2018; 27:456-461. [PMID: 30217302 DOI: 10.1016/j.suronc.2018.05.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/27/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND & PURPOSE Cytoreductive surgery (CRS) plus Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective measure for peritoneal carcinomatosis. The cisplatin (CP) applied in HIPEC carries a risk of kidney injury. This study aims to investigate CP-induced nephrotoxicity post HIPEC and to explore its risk factors. METHODS From January 2012 to July 2013, 99 patients undergoing CRS + HIPEC were retrospectively reviewed. Patients were divided into CP and Non-CP HIPEC groups. The RIFLE classification was used to assess the severity of acute kidney injury (AKI). Renal and hepatic function, concentrations of tumor markers, and postoperative outcomes were compared between groups. RESULTS 47 (47.5%) patients were in the CP HIPEC group, with 52 (52.5%) patients in the Non-CP HIPEC group. 11 (11.1%) patients developed AKI, with 10 of them from the CP HIPEC group. Two patients with CP-contained HIPEC developed acute renal failure. Plasma levels of both urea nitrogen and creatinine were significantly increased in the CP HIPEC group compared with the Non-CP HIPEC group (P < 0.01). However, postoperative pain (scaled score, 4.2 vs. 3.8; P = 0.279), length of hospital stay (18.1 vs. 20.2 days; P = 0.285), hospital costs ($1 3182 vs. $12 640; P = 0.465) and incidence of postoperative complication (25.5% vs. 17.3%; P = 0.337) were similar in both groups, with comparable 3-year overall survival observed (38.6% vs. 31.8%, P = 0.319). A multivariate analysis indicated that use of CP was an independent risk factor for AKI (P = 0.017, 95% CI: 1.277-4.155). CONCLUSIONS Application of CP during HIPEC is associated with an increased risk of nephrotoxicity, without promising long-term survival benefit.
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Affiliation(s)
- Jinning Ye
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Yufeng Ren
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Zhewei Wei
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Jianjun Peng
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Chuangqi Chen
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Wu Song
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Min Tan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China
| | - Yulong He
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China.
| | - Yujie Yuan
- Center of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China; Center of Gastric Cancer, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, PR China.
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