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. 2021 Mar 3;6(2):49-55.
doi: 10.1515/pp-2020-0141. eCollection 2021 Jun.

Is the blood of a surgeon performing HIPEC contaminated by irinotecan, its major metabolites and platinum compounds?

Guillaume Saint-Lorant  1   2 , Simon Rodier  1 , Jean-Marc Guilloit  3 , Sophie Ndaw  4 , Mathieu Melczer  4 , Stéphanie Lagadu  1   5 , Agnès Palix  6 , Raphaël Delépée  1   5
Affiliations

Is the blood of a surgeon performing HIPEC contaminated by irinotecan, its major metabolites and platinum compounds?

Guillaume Saint-Lorant et al. Pleura Peritoneum. .

Abstract

Objectives: Hyperthermic intraperitoneal chemotherapy (HIPEC) is a beneficial surgical technique for patients, but the surgeons are being exposed to cytotoxic drugs. Few biomonitoring studies were led on blood samples in the context of HIPEC. This study aimed to evaluate the surgeon's plasmatic and red blood cell (RBC) contamination by irinotecan, two of its major metabolites and platinum compounds.

Methods: HIPEC procedures performed using the coliseum techniques were observed between September 2015 and April 2018 in a French comprehensive cancer center. Irinotecan and its metabolites SN-38 and APC were dosed by UHPLC with a limit of quantification determined at 50 pg/mL. Platinum compounds were dosed by inductively coupled plasma mass spectrometry with a limit of quantification determined at 16 pg/mL.

Results: Despite collective and personal protective equipment, 80% of plasma samples were contaminated by irinotecan and 33% by platinum compounds out of 21. The results showed that the surgeon was contaminated after HIPEC and even after a period of HIPEC inactivity. Nineteen percent of plasmatic samples and 45% of RBC samples were contaminated by SN-38, the active metabolite of irinotecan. APC was only found in some RBC samples (33%).

Conclusions: Even if this study shows blood contamination by irinotecan, two of its major metabolites (including active SN-38) and platinum compounds both in the plasma and RBC of a surgeon performing the HIPEC procedures, further studies should be performed to confirm these results. Additional studies should be carried out to further investigate the contamination in the context of HIPEC and more broadly in the hospital.

Keywords: HIPEC; antineoplastic drugs; blood contamination.

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Conflict of interest statement

Competing interests: Authors state no conflict of interest.

References

    1. Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J. Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Canc Res 1980;40:256–60. - PubMed
    1. Fujimoto S, Shrestha RD, Kokubun M, Ohta M, Takahashi M, Kobayashi K, et al. . Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding. Ann Surg 1988;208:36–41. - PMC - PubMed
    1. Gilly FN, Carry PY, Sayag AC, Braillon GB, Volloch AA, Panteix GG, et al. . Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia with mitomycin C. Initial experience. Ann Chir 1990;44:545–51. - PubMed
    1. Canbay E, Yonemura Y, Brucher B, Baik SH, Sugarbaker PH. Intraperitoneal chemotherapy and its evolving role in management of gastric cancer with peritoneal metastases. Chin J Canc Res 2014;26:1–3. - PMC - PubMed
    1. Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Gynecologic Oncology Group, et al. . Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 2006;354:34–43. - PubMed

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