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Clinical and pathogenetic justification for the use of therapeutic plasma exchange in the complex of preoperative preparation of patients with non-small cell lung cancer complicated by the inflammatory process

https://doi.org/10.37748/2686-9039-2024-5-1-1

EDN: GWAFXM

Abstract

Purpose of the study. Determination of pathogenetic substantiation and indication criteria for the inclusion of extracorporeal detoxification methods in preoperative preparation of patients with non-small cell lung cancer (NSCLC) complicated by inflammation.

Patients and methods. This study included the data on 222 patients with newly diagnosed stage I–IV NSCLC referred for elective surgical treatment to the Department of Thoracic Oncology, National Medical Centre for Oncology, in 2017–2019. Endogenous intoxication was evaluated in all patients depending on the leukogram results: leukocytic intoxication index (LII), body resistance index (BRI), reactive neutrophil response (RNR), and neutrophil-lymphocyte ratio (NLR). Indicators of the inflammatory response, i. e. interleukin 6 and procalcitonin, were also studied.

Results. 36.5 % of NSCLC patients developed inflammation. That over 70 % of the NSCLC patients showed pronounced clinical and laboratory signs of endogenous intoxication and inhibited protective systems of homeostasis. Initial sub- or decompensated endotoxicosis together with reduced overall reactivity of the body poses a high risk of systemic inflammatory response to antitumor surgical treatment. This justifies the inclusion of extracorporeal detoxification into preoperative preparation of this category of patients as an active preoperative therapy.

Conclusions. Simultaneous elevation of LII, RNR and NLR characterizing the presence of endotoxicosis in sub- and decompensation of endogenous intoxication by own physiological detoxification systems requires an active preoperative preparation with extracorporeal detoxification.

About the Authors

N. D. Ushakova
National Medical Research Centre for Oncology; Rostov State Medical University
Russian Federation

Nataliya D. Ushakova – Dr. Sci. (Med.), professor, anesthesiologist and resusticator, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation; professor of the Anesthesiology and Resuscitation Department, Rostov State Medical University, Rostov-on-Don, Russian Federation

ORCID: https://orcid.org/0000-0002-0068-0881, SPIN: 9715-2250, AuthorID: 571594, ResearcherID: L-6049-2017, Scopus Author ID: 8210961900


Competing Interests:

the authors state that there are no conflicts of interest to disclose



D. A. Rozenko
National Medical Research Centre for Oncology
Russian Federation

Dmitriy A. Rozenko – Cand. Sci. (Med.), chief of the Anesthesiology and Resuscitation Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation

ORCID: https://orcid.org/0000-0002-5563-484X, SPIN: 4658-5058, AuthorID: 917988


Competing Interests:

the authors state that there are no conflicts of interest to disclose



S. N. Tikhonova
National Medical Research Centre for Oncology
Russian Federation

Svetlana N. Tikhonova – MD, anesthesiologist and resuscitator, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation

ORCID: https://orcid.org/0000-0001-6919-3523, SPIN: 5141-1656, AuthorID: 1077917


Competing Interests:

the authors state that there are no conflicts of interest to disclose



D. A. Kharagezov
National Medical Research Centre for Oncology
Russian Federation

Dmitriy A. Kharagezov – Cand. Sci. (Med.), MD, chief of the Thoracic Surgery Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation

ORCID: https://orcid.org/0000-0003-0640-2994, SPIN: 5120-0561, AuthorID: 733789


Competing Interests:

the authors state that there are no conflicts of interest to disclose



N. N. Popova
National Medical Research Centre for Oncology; Rostov State Medical University
Russian Federation

Natalia N. Popova – Cand. Sci. (Med.), MD, anesthesiologist and resuscitator of the Anesthesiology and Resuscitation Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation; assistant of the Department of Oncology, Rostov State Medical University, Rostov-on-Don, Russian Federation

ORCID: https://orcid.org/0000-0002-3891-863X, SPIN: 5071-5970, AuthorID: 854895, Scopus Author ID: 57215858399


Competing Interests:

the authors state that there are no conflicts of interest to disclose



References

1. Merabishvili VM, Yurkova YuP, Shcherbakov АМ, Levchenko EV, Barchuk AA, Krotov NF, et al. Lung cancer (C33, 34). Morbidity, mortality, accuracy of registration, localization and histological structure (population study). Problems in Oncology. 2021;67(3):361–367. (In Russ.). https://doi.org/10.37469/0507-3758-2021-67-3-361-367, EDN: MHNNMT

2. Dobner SYu, Tuzikov SА, Аgeeva ТS, Samtsov ЕN, Dubakov АV, Sinilkin IG, et al. Preoperative and postoperative pulmonary rehabilitation in patients with lung cancer and chronic obstructive pulmonary disease. Siberian Journal of Oncology. (In Russ.). https://doi.org/10.21294/1814-4861-2020-19-1-111-118, EDN: BMYBMY

3. Kit OI, Turkin IN, Kharagezov DA, Lazutin YuN, Leiman IA, Chubaryan AV, et al. Sequential bronchoplastic upper lobectomy as a surgical component of multimodal treatment for synchronous bilateral multiple primary non-small cell lung cancer. Siberian Journal of Oncology. 2022;21(3):143–150. (In Russ.). https://doi.org/10.21294/1814-4861-2022-21-3-143-150, EDN: DGVUWW

4. Tereshchenko IV, Grigoryevskaya ZV, Petukhova IN, Bagirova NS, Vinnikova VD, Vershinskaya VA, et al. Infectious complications caused by non-sporeforming anaerobic bacteria in cancer patients. Relevance of the problem. Siberian Journal of Oncology. 2020;19(4):146–151. (In Russ.). https://doi.org/10.21294/1814-4861-2020-19-4-146-151, EDN: MREQCP

5. Ushakova ND, Shevchenko AN, Chetverikov MV, Zlatnik EYu, Zykova TA. Results of Using Selective Endotoxin Adsorption in Cancer Patients with Sepsis. General Reanimatology. 2014;10(6):32–38. (In Russ.). https://doi.org/10.15360/1813-9779-2014-6-32-38, EDN: TEGAPZ

6. Kim ES, Kim YT, Kang CH, Park IK, Bae W, Choi SM, et al. Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:1317–1326. https://doi.org/10.2147/COPD.S105206

7. Grigoryev EV, Shukevich DL, Plotnikov GP, Kudryavtsev AN, Radivilko AS. Failures of intensive treatment of multiple organ failure: pathophysiology and the need for personification (literature review). Bulletin of Intensive Care named after A. I. Saltanov. 2019;(2):48–57. (In Russ.). https://doi.org/10.21320/1818-474X-2019-2-48-57, EDN: YUXAPP

8. Rubtsov MS, Shukevich DL. Modern extracorporeal methods for critical conditions caused by systemic inflammatory response (review). Russian Journal of Anaesthesiology and Reanimatology. 2019;(4):20–30. (In Russ.). https://doi.org/10.17116/anaesthesiology201904120, EDN: VCZFVQ

9. Razumovskiy AYU, Stepanenko SM, Afukov II, Demakhin AA. Methods of single-lung ventilation in children. Journal of Pediatric Surgery. 2014;18(2):20–25. (In Russ.). EDN: SBYOHF

10. Yaroshetskiy AI, Gritsan AI, Avdeev SN, Vlasenko AV, Eremenko AA, Zabolotskikh IB, et al. Diagnostics and intensive therapy of acute respiratory distress syndrome (clinical guidelines of the Federation of anesthesiologists and reanimatologists of Russia). Russian Journal of Anaesthesiology and Reanimatology. 2020;(2):5–39. (In Russ.). https://doi.org/10.17116/anaesthesiology20200215, EDN: KAMAJL

11. Gorbunova VA, Artamonova EV, Breder VV, Laktionov KK, Moiseenko FV, Reutova EV, et al. Practical recommendations for the drug treatment of non-small cell lung cancer. Malignant Tumors. 2017;7(3S2):28-42. (In Russ.). https://doi.org/10.18027/2224-5057-2017-7-3s2-28-42, EDN: XMKEHJ

12. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020 Jan;70(1):7–30. https://doi.org/10.3322/caac.21590

13. Ostrovsky VK, Makarov SV, Yangolenko DV, Rodionov PN, Kochetkov LN, Asanov BM. The some blood parameters and leucocytic index of intoxication in the evaluation of the severity and in the determination of their prognosis of inflammatory, purulent and pyodestructive diseases of the abdomen and of the lungs. Ulyanovsk Medical and Biological Journal. 2011;(1):73–78. (In Russ.). EDN: OPOPQZ

14. Zahar'jan EA, Ibragimova RJ. Neutrophil-lymphocytal ratio in the patients with multiple organs dysfunction. Messenger of Anesthesiology and Resuscitation. 2023;22(1):51–56. (In Russ.). https://doi.org/10.52420/2071-5943-2023-22-1-51-56, EDN: JWPLTU

15. Sorokin ID, Аfаnаsiev АА, Mаlininа DА. Neutrophil-lymphocytal ratio in the patients with multiple organs dysfunction. Messenger of anesthesiology and resuscitation. 2019;16(3):91–92. (In Russ.). https://doi.org/10.21292/2078-5658-2019-16-3-91-92, EDN: YZUWMD

16. Bazhina ES, Nikulin AV, Khoroshilov SE. Extracorporeal treatments for abdominal sepsis. General Reanimatology. 2015;11(5):45–66. (In Russ.). https://doi.org/10.15360/1813-9779-2015-5-45-66, EDN: UQDZYB

17. Bambauer R, Latza R, Lentz MR. Therapeutic plasma exchange and selective plasma separation methods: fundamental technologies, pathophysiology, and clinical results. 3rd edition. Pabst Science Publishers; 2008, 428 p.

18. Ushakova ND, Tikhonova SN, Rozenko DA. Hemosorption by a Column Adsorber Based on Hyper-Cross-Linked Styrene-Divinylbenzene Copolymer with Immobilized Lipopolysaccharide-Selective Ligand in Combined Intensive Care of Lung Cancer-Related Postoperative Acute Lung Injury (Case Report). General Reanimatology. 2020;16(4):14–20. (In Russ.). https://doi.org/10.15360/1813-9779-2020-4-14-20, EDN: DUVYXY


Supplementary files

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For citations:


Ushakova N.D., Rozenko D.A., Tikhonova S.N., Kharagezov D.A., Popova N.N. Clinical and pathogenetic justification for the use of therapeutic plasma exchange in the complex of preoperative preparation of patients with non-small cell lung cancer complicated by the inflammatory process. South Russian Journal of Cancer. 2024;5(1):6-16. https://doi.org/10.37748/2686-9039-2024-5-1-1. EDN: GWAFXM

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