Introduction/Background Cytoreductive surgery associated with hyperthermic intraperitoneal chemotherapy (HIPEC), using cisplatin, is an option in advanced ovarian cancer treatment. Cisplatin may cause renal failure, both after systemic or intraperitoneal administration. It can accumulate and lead to nephrotoxicity in one third of intravenous prescription and up to 40% of acute renal failure for the IP route with progressive and irreversible chronic renal failure.In addition to preoperative hyperhydration, Sodium Thiosulfate (ST) has been used in the prevention and treatment of Cisplatin-induced toxicity, particularly to prevent renal toxicity.The objective of our study was to evaluate the interest of preoperative intravenous hydration alone or in combination with sodium thiosulfate to prevent nephrotoxicity induced during the use of intraperitoneal Cisplatin in patients who have undergone a cytoreductive surgery with HIPEC.
Methodology A retrospective single-tertiary-center analysis of all consecutive patients treated by cytoreductive surgery with Cisplatin-based HIPEC between January 01, 2015 and July 30, 2020. All types of PC were included. There were three consecutive periods of study corresponding to 3 different treatments. A first group was treated with preoperative hyperhydration alone (group 1 – PHH), a second-one with preoperative hyperhydration (3L/24 h of Ringer-Lactate) with addition of ST (group 2 – PHH + ST) and a third-one with ST alone (group 3 – ST).
Results Period study included 230 consecutive patients underwent. Median age was 59 years (interquartile range 49 – 68 years), with 76% women. Higher rate of complete cytoreduction (CC0) were achieved in PHH + TS and TS alone (92% and 97%, respectively, vs 77%, p < 0.001). PHH + TS and TS alone had better postoperative renal function without acute injury compared to group 1 (p<0.001).
Conclusion In addition to the nephroprotective benefit, sodium thiosulfate also appears to be associated with better cytoreduction results. Hyperhydration does not provide any additional benefit.
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