Nephrotoxicity and long-term survival investigations for patients with peritoneal carcinomatosis using hyperthermic intraperitoneal chemotherapy with cisplatin: A retrospective cohort study.

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.

• Authors: Jinning Ye, Yufeng Ren, Zhewei Wei, Jianjun Peng, Chuangqi Chen, Wu Song, Min Tan, Yulong He, Yujie Yuan
• Journal: Surgical oncology (Surg Oncol) Vol. 27 Issue 3 Pg. 456-461 (Sep 2018) ISSN: 1879-3320 [Electronic] Netherlands
• PMID: 30217302 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Case-Control Studies
• Chemotherapy, Adjuvant
• Chemotherapy, Cancer, Regional Perfusion (adverse effects, mortality)
• Cisplatin (therapeutic use)
• Combined Modality Therapy
• Cytoreduction Surgical Procedures (adverse effects, mortality)
• Female
• Follow-Up Studies
• Humans
• Hyperthermia, Induced (adverse effects, mortality)
• Kidney Diseases (etiology, mortality, pathology)
• Male
• Middle Aged
• Peritoneal Neoplasms (mortality, pathology, therapy)
• Prognosis
• Retrospective Studies
• Survival Rate