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The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer
Cisplatin based hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to prolong recurrence free and overall survival of women with ovarian cancer who have responded to neoadjuvant chemotherapy. The aim of this study was to assess the impact of cytoreductive surgery with or without the ad...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185237/ https://www.ncbi.nlm.nih.gov/pubmed/34141848 http://dx.doi.org/10.1016/j.gore.2021.100796 |
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author | Glennon, Kate Mulligan, Karen Carpenter, Kirsten Mooney, Ruth Mulsow, Jurgen McCormack, Orla Boyd, William Walsh, Tom McVey, Ruaidhri Thompson, Claire Ryan, Brid Padfield, Katie Murray, Patrick Brennan, Donal J |
author_facet | Glennon, Kate Mulligan, Karen Carpenter, Kirsten Mooney, Ruth Mulsow, Jurgen McCormack, Orla Boyd, William Walsh, Tom McVey, Ruaidhri Thompson, Claire Ryan, Brid Padfield, Katie Murray, Patrick Brennan, Donal J |
author_sort | Glennon, Kate |
collection | PubMed |
description | Cisplatin based hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to prolong recurrence free and overall survival of women with ovarian cancer who have responded to neoadjuvant chemotherapy. The aim of this study was to assess the impact of cytoreductive surgery with or without the addition of HIPEC on renal function. METHOD: This is a retrospective case-controlled study at a tertiary teaching hospital in Dublin, Ireland. All patients who had interval cytoreductive surgery (CRS) and HIPEC from October 2017 to October 2020 were included. A cohort of patients who had interval CRS without HIPEC were included as a control. Sodium thiosulphate (ST) was added to the HIPEC protocol in 2019. In order to assess the impact of ST as a renal protectant, renal function and post-operative outcomes were compared between the groups. RESULTS: Sixty patients who had interval CRS were included, thirty of whom received cisplatin-based HIPEC. Seven received cisplatin 50 mg/m(2) without the addition of ST. Twenty three patients received cisplatin 100 mg/m(2) and ST. There were no statistically differences in age, body mass index BMI, American society of anaesthesia score, estimated blood loss or peritoneal cancer index between the cohorts (p > 0.05). The only episode of acute kidney injury (AKI) was within the HIPEC cohort, after cisplatin 50 mg/m(2) (without ST) and this was sustained at three months. In contrast, no patients within the CRS cohort or cisplatin 100 mg/m(2) that received the addition of ST, sustained a renal injury and all had a creatinine within the normal range at three days post operatively. CONCLUSION: The renal toxicity associated with cisplatin HIPEC and major abdominal surgery can be minimised with careful preoperative optimisation, intra operative fluid management and attention to renal function. The addition of sodium thiosulphate is a safe and effective method to minimise toxicity and should be added to any cisplatin HIPEC protocol. |
format | Online Article Text |
id | pubmed-8185237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-81852372021-06-16 The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer Glennon, Kate Mulligan, Karen Carpenter, Kirsten Mooney, Ruth Mulsow, Jurgen McCormack, Orla Boyd, William Walsh, Tom McVey, Ruaidhri Thompson, Claire Ryan, Brid Padfield, Katie Murray, Patrick Brennan, Donal J Gynecol Oncol Rep Case Reports and Case Series Cisplatin based hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to prolong recurrence free and overall survival of women with ovarian cancer who have responded to neoadjuvant chemotherapy. The aim of this study was to assess the impact of cytoreductive surgery with or without the addition of HIPEC on renal function. METHOD: This is a retrospective case-controlled study at a tertiary teaching hospital in Dublin, Ireland. All patients who had interval cytoreductive surgery (CRS) and HIPEC from October 2017 to October 2020 were included. A cohort of patients who had interval CRS without HIPEC were included as a control. Sodium thiosulphate (ST) was added to the HIPEC protocol in 2019. In order to assess the impact of ST as a renal protectant, renal function and post-operative outcomes were compared between the groups. RESULTS: Sixty patients who had interval CRS were included, thirty of whom received cisplatin-based HIPEC. Seven received cisplatin 50 mg/m(2) without the addition of ST. Twenty three patients received cisplatin 100 mg/m(2) and ST. There were no statistically differences in age, body mass index BMI, American society of anaesthesia score, estimated blood loss or peritoneal cancer index between the cohorts (p > 0.05). The only episode of acute kidney injury (AKI) was within the HIPEC cohort, after cisplatin 50 mg/m(2) (without ST) and this was sustained at three months. In contrast, no patients within the CRS cohort or cisplatin 100 mg/m(2) that received the addition of ST, sustained a renal injury and all had a creatinine within the normal range at three days post operatively. CONCLUSION: The renal toxicity associated with cisplatin HIPEC and major abdominal surgery can be minimised with careful preoperative optimisation, intra operative fluid management and attention to renal function. The addition of sodium thiosulphate is a safe and effective method to minimise toxicity and should be added to any cisplatin HIPEC protocol. Elsevier 2021-05-26 /pmc/articles/PMC8185237/ /pubmed/34141848 http://dx.doi.org/10.1016/j.gore.2021.100796 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Reports and Case Series Glennon, Kate Mulligan, Karen Carpenter, Kirsten Mooney, Ruth Mulsow, Jurgen McCormack, Orla Boyd, William Walsh, Tom McVey, Ruaidhri Thompson, Claire Ryan, Brid Padfield, Katie Murray, Patrick Brennan, Donal J The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title | The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title_full | The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title_fullStr | The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title_full_unstemmed | The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title_short | The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
title_sort | addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer |
topic | Case Reports and Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8185237/ https://www.ncbi.nlm.nih.gov/pubmed/34141848 http://dx.doi.org/10.1016/j.gore.2021.100796 |
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