Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy
Background: Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) has been used to treat various peritoneal malignancies. Cisplatin and mitomycin C (MMC) are agents commonly used in these procedures and, individually, each has been associated with acute kidney injury (AKI). There is limited...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-01-01
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| Series: | International Journal of Hyperthermia |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/02656736.2019.1597175 |
| _version_ | 1828231920168730624 |
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| author | Ravish Kapoor Kristen Ashlee Robinson Juan Pablo Cata Pascal Owusu-Agyemang Jose Miguel Soliz Michael Hernandez Paul Mansfield Brian Badgwell |
| author_facet | Ravish Kapoor Kristen Ashlee Robinson Juan Pablo Cata Pascal Owusu-Agyemang Jose Miguel Soliz Michael Hernandez Paul Mansfield Brian Badgwell |
| author_sort | Ravish Kapoor |
| collection | DOAJ |
| description | Background: Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) has been used to treat various peritoneal malignancies. Cisplatin and mitomycin C (MMC) are agents commonly used in these procedures and, individually, each has been associated with acute kidney injury (AKI). There is limited literature on the complications associated with the use of both agents in HIPEC. Therefore, we sought to determine the incidence of nephrotoxicity and electrolyte abnormalities in patients undergoing laparoscopic HIPEC using this chemotherapeutic combination. Methods: We retrospectively evaluated patients undergoing laparoscopic HIPEC for gastric or gastroesophageal adenocarcinoma using both cisplatin and MMC. Sodium thiosulfate was given for renal protection and kidney function was evaluated daily up to postoperative day #2. Details regarding patient characteristics, selection criteria, chemotherapeutic regimen, perioperative lab values and anesthetic management were collected. Results: Twenty-three patients underwent 31 laparoscopic HIPEC procedures. Fifteen (65%) were male and the median age was 57 (range 21–75). Thirteen procedures were associated with an elevation in creatinine (Cr) with the median difference between POD#2 and baseline being 0.09 mg/dL (range 0–0.43). The glomerular filtration rate median difference between POD#2 and baseline was −17 mL/min/1.37 sq. m (range −42 to 11). No cases demonstrated AKI, defined as a 50% increase in Cr levels above baseline. An 84% incidence of postoperative hypophosphatemia (26/31) and 94% incidence of postoperative hypocalcemia (29/31) was observed. Conclusion: The laparoscopic approach to HIPEC using both cisplatin and MMC in our cohort was not associated with an increased incidence of AKI. The incidence of hypophosphatemia and hypocalcemia needs further evaluation to determine the exact etiology. Precis’ statement: We retrospectively studied the association of AKI with the combined use of cisplatin and MMC in laparoscopic HIPEC. |
| first_indexed | 2024-04-12T19:12:15Z |
| format | Article |
| id | doaj.art-29e249f7c103412aaee6045dc7d7d1fe |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-04-12T19:12:15Z |
| publishDate | 2019-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-29e249f7c103412aaee6045dc7d7d1fe2022-12-22T03:19:50ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572019-01-0136149249710.1080/02656736.2019.15971751597175Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapyRavish Kapoor0Kristen Ashlee Robinson1Juan Pablo Cata2Pascal Owusu-Agyemang3Jose Miguel Soliz4Michael Hernandez5Paul Mansfield6Brian Badgwell7The University of Texas MD Anderson Cancer CenterThe University of Texas MD Anderson Cancer CenterThe University of Texas MD Anderson Cancer Center. Anesthesiology and Surgical Oncology Research GroupThe University of Texas MD Anderson Cancer Center. Anesthesiology and Surgical Oncology Research GroupThe University of Texas MD Anderson Cancer Center. Anesthesiology and Surgical Oncology Research GroupThe University of Texas MD Anderson Cancer CenterThe University of Texas MD Anderson Cancer CenterThe University of Texas MD Anderson Cancer CenterBackground: Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) has been used to treat various peritoneal malignancies. Cisplatin and mitomycin C (MMC) are agents commonly used in these procedures and, individually, each has been associated with acute kidney injury (AKI). There is limited literature on the complications associated with the use of both agents in HIPEC. Therefore, we sought to determine the incidence of nephrotoxicity and electrolyte abnormalities in patients undergoing laparoscopic HIPEC using this chemotherapeutic combination. Methods: We retrospectively evaluated patients undergoing laparoscopic HIPEC for gastric or gastroesophageal adenocarcinoma using both cisplatin and MMC. Sodium thiosulfate was given for renal protection and kidney function was evaluated daily up to postoperative day #2. Details regarding patient characteristics, selection criteria, chemotherapeutic regimen, perioperative lab values and anesthetic management were collected. Results: Twenty-three patients underwent 31 laparoscopic HIPEC procedures. Fifteen (65%) were male and the median age was 57 (range 21–75). Thirteen procedures were associated with an elevation in creatinine (Cr) with the median difference between POD#2 and baseline being 0.09 mg/dL (range 0–0.43). The glomerular filtration rate median difference between POD#2 and baseline was −17 mL/min/1.37 sq. m (range −42 to 11). No cases demonstrated AKI, defined as a 50% increase in Cr levels above baseline. An 84% incidence of postoperative hypophosphatemia (26/31) and 94% incidence of postoperative hypocalcemia (29/31) was observed. Conclusion: The laparoscopic approach to HIPEC using both cisplatin and MMC in our cohort was not associated with an increased incidence of AKI. The incidence of hypophosphatemia and hypocalcemia needs further evaluation to determine the exact etiology. Precis’ statement: We retrospectively studied the association of AKI with the combined use of cisplatin and MMC in laparoscopic HIPEC.http://dx.doi.org/10.1080/02656736.2019.1597175intraperitoneal chemotherapyhyperthermiakidney injurycisplatinmitomycin c |
| spellingShingle | Ravish Kapoor Kristen Ashlee Robinson Juan Pablo Cata Pascal Owusu-Agyemang Jose Miguel Soliz Michael Hernandez Paul Mansfield Brian Badgwell Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy International Journal of Hyperthermia intraperitoneal chemotherapy hyperthermia kidney injury cisplatin mitomycin c |
| title | Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| title_full | Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| title_fullStr | Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| title_full_unstemmed | Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| title_short | Assessment of nephrotoxicity associated with combined cisplatin and mitomycin C usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| title_sort | assessment of nephrotoxicity associated with combined cisplatin and mitomycin c usage in laparoscopic hyperthermic intraperitoneal chemotherapy |
| topic | intraperitoneal chemotherapy hyperthermia kidney injury cisplatin mitomycin c |
| url | http://dx.doi.org/10.1080/02656736.2019.1597175 |
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