Commentary: Cisplatin-induced nephrotoxicity following cytoreductive surgery and heated intraoperative chemotherapy for malignant pleural mesothelioma

Our plain-English summary of Commentary: Cisplatin-induced nephrotoxicity following cytoreductive surgery and heated intraoperative chemotherapy for malignant pleural mesothelioma, by S.S. Groth, R.T. Ripley (The Journal of Thoracic and Cardiovascular Surgery, 2021).

The study

• Authors: S.S. Groth, R.T. Ripley
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2021;161(4):1519-1520
• Type of article: Editorial, Comment
• Read it: PubMed · Publisher

In plain English

This article is a short commentary, not a new study. The authors, from Baylor College of Medicine in Houston, wrote about a separate study by Hod and colleagues on kidney damage after surgery for malignant pleural mesothelioma combined with heated chemotherapy using the drug cisplatin, given during the operation. As the commentary describes it, that separate study covered 503 patients who had cytoreductive surgery, with or without heated cisplatin, over 9 years. It reported that 48.3% of patients given the heated chemotherapy had some degree of acute kidney injury and 3.2% needed hemodialysis. The most severe stage of kidney injury (stage 3) was associated with a 2.7-fold increased risk of death. The commentary authors cited earlier work from the same hospital: amifostine alone did not protect the kidneys well enough, but a combination of protective measures reduced kidney injury. The authors concluded that several strategies used together are needed to reduce this risk. They said many questions remain unanswered, including the best duration and drug combination.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Invited commentary (editorial) on another study published in the same journal; it reports no new data of its own
• Who was studied: No population of its own. The commentary discusses a separate study by Hod and colleagues of 503 patients who had cytoreductive surgery for malignant pleural mesothelioma, with or without cisplatin-based heated intraoperative chemotherapy, over a 9-year period.
• Exposure: Cisplatin-based heated intraoperative chemotherapy (HIOC) given with cytoreductive surgery for malignant pleural mesothelioma. The exposure is a treatment, not asbestos.
• Main results:
  • Finding of the separate study by Hod and colleagues, as reported in the commentary (not this article's own result): 48.3% of patients who underwent HIOC had some degree of acute kidney injury (AKI), and 3.2% required hemodialysis.
  • Finding of the separate study by Hod and colleagues, as reported in the commentary: on multivariable analysis, stage 3 AKI was associated with a 2.7-fold increased risk of death.
  • Earlier work from the Brigham group, cited by the commentary: amifostine alone did not give adequate kidney protection. A combination of amifostine, sodium thiosulfate and proactive fluid management reduced the incidence of AKI.
  • The commentary authors stated that the optimal duration and combination of chemotherapy agents for HIOC is unknown.
• The authors' conclusion: The authors concluded that multimodal strategies are needed to minimize the risk and severity of acute kidney injury after cytoreductive surgery and platinum-based heated intraoperative chemotherapy for mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Cisplatin, Nephrotoxicity, Cytoreductive Surgery, Chemotherapy, Pleural Mesothelioma.

Related studies

• Acute kidney injury after cytoreductive surgery and hyperthermic intraoperative cisplatin chemotherapy for malignant pleural mesothelioma — T. Hod, K.J. Freedberg, et al. (2021)
• Pharmacokinetics of doxorubicin and cisplatin used in intraoperative hyperthermic intrathoracic chemotherapy after cytoreductive surgery for malignant pleural mesothelioma and pleural thymoma — S. van Ruth, O. van Tellingen, et al. (2003)
• Commentary: Acute kidney injury after intrapleural cisplatin: Minimizing collateral damage — M.I. Ebright (2021)
• Thoracic complications in patients undergoing intraperitoneal heated chemotherapy with mitomycin following cytoreductive surgery — M.Y. Chen, C. Chiles, et al. (1997)
• Cytoreductive surgery and heated intraperitoneal chemotherapy for peritoneal carcinomatosis from rare etiologies — M. Mah, L.A. Mack, et al. (2019)
• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in pediatric patients with peritoneal mesothelioma: a single institution experience and long term follow up — P. Malekzadeh, M. Good, et al. (2021)

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