The incidence and risk factors of hepatotoxicity induced by perioperative hyperthermic intraperitoneal chemotherapy in gastrointestinal carcinoma patients: a retrospective study

Zheng, Zhewen; Yu, Haojun; Xiong, Bin; Shen, Shuangting; Yang, Hui; Zhou, Youwen

doi:10.2147/ott.s170398

Cited by 5 publications

(5 citation statements)

References 26 publications

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“…In a retrospective study on severe neutropenia after HIPEC with mitomycin C, Lambert et al [18] found that for every 5-unit (mg/ m 2 ) increase in mitomycin C dosage, there was 3.37-fold increase in the risk of severe neutropenia (HR ¼ 3.37, 95%CI: 1.72e6.63). In another study on CRS þ HIPEC for gastrointestinal carcinoma patients, Zheng et al [19] investigated the risk factors of hepatotoxicity, and found cisplatin-docetaxel HIPEC regimen was an independent risk factor. In a retrospective study on identification of risk factors associated with postoperative acute kidney injury after CRS þ HIPEC, platinum-based HIPEC (P < 0.001, OR ¼ 3.04, 95%CI: 1.71e5.39) was one of the independent predictor factors [20].…”

Section: System Distributionmentioning

confidence: 99%

Perioperative safety after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei from appendiceal origin: Experience on 254 patients from a single center

et al. 2020

European Journal of Surgical Oncology

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Objective: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a standard treatment for pseudomyxoma peritonei (PMP) recommended by Peritoneal Surface Oncology Group International (PSOGI). The study is to analyze the incidence of perioperative serious adverse events (SAEs) of CRS þ HIPEC to treat PMP patients, and identify the risk factors, for guiding the prevention of SAEs. Methods: This is a retrospective study on the PMP database established at our center. The clinicopathological features, treatment details and SAEs information on the PMP patients are systematically established in this database. The incidence, organ system distribution and severity of perioperative SAEs are analyzed. Univariate and multivariate analyses are performed to identify the independent risk factors. Results: Among the 272 CRS þ HIPEC procedures for 254 PMP patients, there are 93 (34.2%) SAEs. Six systems are involved in the SAEs, including infections (9.6%), digestive system (8.1%), respiratory system (6.3%), cardiovascular system (5.5%), hematological system (2.9%), and urinary system (1.5%), in terms of frequency. In terms of severity, the majority is grade III SAEs (27.9%), followed by grade IV SAEs (4.8%) and grade V SAEs (1.5%). Univariate analysis reveals 4 risk factors for perioperative SAEs: HIPEC regimens (P ¼ 0.020), PCI (P ¼ 0.025), intraoperative red blood cell transfusion volume (P ¼ 0.004), and intraoperative blood loss volume (P ¼ 0.002). Multivariate and logistic regression model analysis identifies only one independent risk factor for perioperative SAEs: intraoperative blood loss volume (P ¼ 0.001, OR ¼ 0.344, 95%CI: 0.182e0.649). Conclusions: PMP patients treated by CRS þ HIPEC at experienced centers could have acceptable safety. Improving the surgical techniques and developing the integrated hemostasis techniques are essential to reduce intraoperative blood loss and decrease SAEs rate.

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Section: System Distributionmentioning

confidence: 99%

Perioperative safety after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei from appendiceal origin: Experience on 254 patients from a single center

et al. 2020

European Journal of Surgical Oncology

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“…(2) Pre-existing dyslipidemia indirectly contributes to liver damage after chemotherapy. Most chemotherapeutic drugs are cytotoxic and immunosuppressive agents, causing a certain degree of damage to the liver themselves [17]. Chronic liver damage is present in patients with lipid metabolism disorders, resulting in a decreased drug metabolism capacity and aggravation of liver damage.…”

Section: Discussionmentioning

confidence: 99%

Effect of lipid metabolism disorder on liver function in patients with malignant tumors after chemotherapy: a case-control study

et al. 2019

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Background This study aims to investigate the effect of lipid metabolism disorder on liver function in patients with malignant tumors after chemotherapy. Method A total of 428 patients with malignant tumors with normal liver function in our hospital between May 2013 to June 2018 were divided into an observation group (lipid metabolism disorder, n = 265) and control group (normal lipid metabolism, n = 163). The lipid metabolism levels and liver damage of the two groups were compared before and after chemotherapy. Results No significant differences in age, gender, body mass index, tumor types, history of surgery, levels of alanine aminotransferase (ALT; an indicator of liver function), and chemotherapy regimen were observed between the two groups. However, the observation group showed increased levels of total cholesterol ( P = 0.000), triglycerides ( P = 0.000), and low-density lipoprotein ( P = 0.01), as well as decreased levels of high-density lipoprotein ( P = 0.000) before chemotherapy compared with the control group. Furthermore, patients with lipid metabolism disorders were more likely to develop abnormal liver function after chemotherapy. Moreover, mixed lipid metabolism disorder was more likely to cause severe liver damage after chemotherapy. Additionally, the number of patients with lipid metabolism disorders after chemotherapy ( n = 367) was significantly increased compared with before chemotherapy ( n = 265) ( P < 0.01), indicating that chemotherapy might induce or aggravate an abnormal lipid metabolism. Conclusions After receiving chemotherapy, patients with malignant tumors presenting lipid metabolism disorders are more prone to liver damage and lipid metabolism disorders than patients with a normal lipid metabolism.

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“…The therapy combined hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) is the most effective strategy for the treatment of PC by removing the visible cancer tissues of peritoneum and abdominal and pelvic cavity through CRS, and then removing the residual micro cancer foci through the synergistic effect of HIPEC thermochemotherapy. However, there are disputes about this treatment due to its correlation with high recurrence rate and toxic side effects [ 6 ]. Furthermore, though several authoritative guides are practical [ 7 ], the individual heterogeneity of tumor location and genotype contribute to the diverse specific regimens in terms of drug regimen, infusion volume, duration and PM concentration [ 8 , 9 ], which also increased the uncertainty of the curative effect.…”

Section: Introductionmentioning

confidence: 99%

Lobaplatin hyperthermic intraperitoneal chemotherapy plus cytoreduction and rechallenge using cetuximab for wild-type RAS peritoneal metastatic colon cancer: a case report and literature review

Dai

Cai

et al. 2022

BMC Gastroenterol

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Background Synchronous peritoneal metastasis of colorectal cancer usually predicts a bleak prognosis. Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) have brought a glimmer of hope to the treatment of peritoneal cancer. Few cases treated with lobaplatin have been reported in the literature and the regimen is controversial. In this case, the comprehensive treatment scheme of lobaplatin-based HIPEC plus CRS and rechallenge using cetuximab plus systemic chemotherapy is effective, especially for the patients with left colon cancer (wild-type RAS). Case presentation A 49 year-old man with signet ring cell carcinoma of sigmoid colon with extensive abdominal metastasis (wild-type RAS) was hospitalized with prolonged abdominal pain, distention and abdominal mass. After receiving HIPEC with lobaplatin and XELOX regimen combined with cetuximab for eight cycles, the patient had been treated with the FOLFIRI regimen and cetuximab for 24 cycles, which discontinued due to myelosuppression. Because the disease recurred unfortunately 4 months later, the FOLFIRI + cetuximab regimen was initiated again and stopped after two cycles. Intestinal obstruction occurred 1 month later, so open total colectomy, CRS + HIPEC and ileorectal anastomosis were performed. Capecitabine adjuvant chemotherapy was administered, followed by the maintenance therapy with FOLFIRI + cetuximab regimen. After that, the patient has been in relatively stable condition. By August 2021, the overall survival is more than 45 months, which displays significant curative effect. Conclusion For peritoneal metastasis from left colon cancer, the management with CRS + lobaplatin HIPEC and rechallenge of systemic chemotherapy plus targeted medicine based on gene detection can dramatically improve prognosis and extend the overall survival.

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The incidence and risk factors of hepatotoxicity induced by perioperative hyperthermic intraperitoneal chemotherapy in gastrointestinal carcinoma patients: a retrospective study

Cited by 5 publications

References 26 publications

Perioperative safety after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei from appendiceal origin: Experience on 254 patients from a single center

Perioperative safety after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei from appendiceal origin: Experience on 254 patients from a single center

Effect of lipid metabolism disorder on liver function in patients with malignant tumors after chemotherapy: a case-control study

Lobaplatin hyperthermic intraperitoneal chemotherapy plus cytoreduction and rechallenge using cetuximab for wild-type RAS peritoneal metastatic colon cancer: a case report and literature review

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