İntraperitoneal hipertermik kemoterapi epitelyal yumurtalık kanseri olan hastalarda postoperatif hipomagnezemi riskini artırır

Öz

Amaç: İntraperitoneal hipertermik kemoterapi (HİPEK), maksimal sitoredüktif cerrahiyi (SC) takiben epitelyal yumurtalık kanseri (EYK) olan hastalar için ortaya çıkan bir tedavi yöntemidir. Bu çalışma, SC-HİPEK uygulanan EYK hastalarında yüksek serum kreatinin düzeyleri olmadan hipomagnezemi gelişimini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Eylül 2014-Ağustos 2018 tarihleri arasında İstanbul'daki iki üçün basamak hastanede SC sonrası HIPEC uygulanan ileri evre EYK hastalarını (n = 43) inceleyen retrospektif bir çalışmadır. Bulgular: Bu retrospektif çalışmaya toplam 43 EYK hastası dahil edildi. Bunlardan sekizi dahil edilme kriterlerini karşıladı. Bu çalışmada hipomagnezemi insidansı %18,6 olarak bulundu. Ortalama hipomagnezemi başlangıç süresi üç gündü (aralık, 1-6 gün). Sisplatin ile tedavi edilen 32 hastanın beşinde (%15,6), karboplatin ile tedavi edilen 10 hastanın 2'sinde (%10) ve mitomisin C ile tedavi edilen bir hastada hipomagnezemi gelişti. Hiçbir hastada nörolojik bir semptom saptanmadı. Sonuç: SC-HİPEK uygulanacak EOC hastalarının tedavisinde hipomagnezemi dahil çoklu morbiditeler düşünülmelidir. Hipomagnezemi, SC-HİPEK ile ilişkili potansiyel bir komplikasyondur ve ameliyat öncesi tahmin edilemez. Bu çalışmanın sonuçları hipomagnezemiyi ekarte etmek ve erken tedavisini saptamak için ameliyat öncesi ve sonrası dönemde magnezyum düzeylerinin rutin olarak ölçülmesini önermektedir.

Anahtar Kelimeler

• yumurtalık kanseri,HİPEK,sisplatin,hipomagnezemi,nefrotoksisite

Hyperthermic intraperitoneal chemotherapy increases the risk for postoperative hypomagnesemia in patients with epithelial ovarian cancer

Öz

Objective: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an emerging treatment modality for patients with epithelial ovarian cancer (EOC) following maximal cytoreductive surgery (CRS). This study aims to evaluate the development of hypomagnesemia without elevated serum creatinine levels in patients with EOC who underwent CRS-HIPEC. Materials and Methods: It was a retrospective study analyzing the patients (n=43) with advanced stage EOC undergoing HIPEC following the CRS at two tertiary hospitals in Istanbul between September 2014 and August 2018. Results: A total of 43 patients with EOC were enrolled in this retrospective study. Eight of them met the inclusion criteria. The incidence of hypomagnesemia was found as 18.6% in this study. The mean onset time of hypomagnesemia was three days (range, 1-6 days). Hypomagnesemia developed in five of 32 patients (15.6%) treated with cisplatin, 2 of 10 patients (10%) treated with carboplatin, and one patient treated with mitomycin C. None of the patients had a neurological symptom. Conclusion: Multiple morbidities, including hypomagnesemia, must be considered in the management of patients with EOC undergoing CRS-HIPEC. Hypomagnesemia is a potential complication associated with CRS-HIPEC, and it cannot be predicted preoperatively. The results of this study suggest routine measurement of magnesium levels in the preoperative and postoperative period in order to rule out hypomagnesemia and when found its early management.

Anahtar Kelimeler

• ovarian cancer,HIPEC,cisplatin,hypomagnesemia,nephrotoxicity

Kaynakça

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