Postoperative complications in patients receiving suramin therapy

Area of Science:

• Oncology
• Pharmacology
• Surgical Oncology

Background:

• Suramin, an antiparasitic drug, is under investigation for its antineoplastic properties.
• Known toxicities include adrenal/renal insufficiency, coagulation abnormalities, immunosuppression, and polyneuropathy.
• These adverse effects may increase postoperative morbidity in surgical patients.

Purpose of the Study:

• To retrospectively review postoperative complications in patients who received suramin.
• To assess the safety and potential risks associated with surgery in patients treated with suramin.

Main Methods:

• A 5-year retrospective review of 171 patient charts.
• Identified 14 patients who underwent major surgery during or within 1 year of suramin administration.
• Patients received hydrocortisone replacement therapy during suramin treatment.

Main Results:

• Eighteen complications occurred in five patients across 18 major surgical procedures.
• Predominant complications included hemorrhage (5), impaired wound healing (3), and bowel dysmotility (2).
• A significant correlation was found between complications and the interval from suramin completion to surgery (p < 0.0005), with most occurring within the first month. Longer operation times and blood transfusion amounts also correlated with morbidity.

Conclusions:

• Avoidance of elective surgery during the first month post-suramin therapy is recommended.
• Heightened awareness of potential bleeding and wound healing issues is necessary for patients requiring emergent surgery after suramin treatment.