Changing survival of people with myeloma and end stage kidney disease: A cohort study using Australian and New Zealand dialysis and transplant registry 1963–2013

Webster, Angela C; Irish, Ashley; Kelly, Patrick J.

doi:10.1111/nep.12985

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…The SMRs of patients with kidney failure who commenced dialysis were almost three times higher compared with age- and sex-matched controls in the general population, with the excess mortality predominantly observed in cancers that were directly responsible for kidney failure, such as multiple myeloma [ 14 ]. For patients with multiple myeloma, the predicted 5-year survival ranged between 13% and 28%, with the poorest survival occurring in older patients [ 25 ]. However, the clinical outcome of patients with kidney failure and prior cancers other than multiple myeloma remains poorly defined, with our study reporting that the survival on dialysis following the development of cancer recurrence or new cancer was relatively poor.…”

Section: Discussionmentioning

confidence: 99%

The incidence of cancer recurrence and new cancer following commencement of dialysis

Lim

Ooi

Pankaj

et al. 2022

Clinical Kidney Journal

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Background Patients with kidney failure have a higher cancer risk compared to the age-matched general population. However, the outcomes of incident dialysis patients with a prior cancer history are unknown. Methods Using Australia and New Zealand Dialysis and Transplant Registry data (2000-2019), the outcomes and survival probabilities of incident dialysis patients with prior cancers and have experienced a cancer recurrence or have developed a new cancer after dialysis commencement were described. Results Of 4912 patients with prior cancers before dialysis commencement, 323 (7%) and 343 (7%) patients experienced cancer recurrence or developed new cancers post-dialysis initiation, respectively. The median (IQR) time from dialysis commencement to cancer recurrence was 1.2 (0.5-2.8) years, and was 2.0 (0.7-4.0) years for new cancer occurence. Of those with cancer recurrence, 80% presented with metastatic disease and 1 in 2 patients died from cancer, with a median time from cancer recurrence to death of 0.5 (0.2-1.7) years. Of those who developed new cancer, urinary tract and respiratory cancers were the most frequent cancer types, with a median time from new cancer diagnosis to death of 1.3 (0.4-3.1) years. The 3-year survival probabilities on dialysis following cancer recurrence and new cancer were 19% (95%CI 15%,24%) and 41% (35%,47%), respectively. Conclusion Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with less than 50% surviving beyond 3-years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients.

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Section: Discussionmentioning

confidence: 99%

The incidence of cancer recurrence and new cancer following commencement of dialysis

Lim

Ooi

Pankaj

et al. 2022

Clinical Kidney Journal

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“…Either PD or IHD is usually applied in the chronic maintenance phase of ESKD even with malignant disease 7) .…”

Section: Discussionmentioning

confidence: 99%

Family-centered shared decision-making in choosing modalities for renal replacement therapy in a pediatric patient with malignant disease

Sugawara

Miura

Ishikawa

et al. 2021

Nihon Shoni Jinzobyo Gakkai Zasshi

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“…The overall 5-year survival for renal dialysis varies between 35.8% and 50% dependent on age and comorbidities. 80 Renal transplantation has shown to significantly improve overall mortality by up to 86% at 5 years. 80 It is noted that the vast majority of localised prostate cancers have 5-year cancer-specific survival rates in excess of 90%.…”

Section: Prostate Cancer Screeningmentioning

confidence: 99%

“…80 Renal transplantation has shown to significantly improve overall mortality by up to 86% at 5 years. 80 It is noted that the vast majority of localised prostate cancers have 5-year cancer-specific survival rates in excess of 90%. 81…”

Section: Prostate Cancer Screeningmentioning

confidence: 99%

The role of localised prostate cancer treatment in renal transplant patients: A systematic review

et al. 2023

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ObjectiveTo systematically review and critically appraise all treatment options for localised prostate cancer in renal transplant candidates and recipients.MethodA systematic review was conducted adhering to PRISMA guidelines. Searches were performed in the Cochrane Library, Embase, Medline, the Transplant Library and Trip database for studies published up to September 2022. Risk of bias was assessed with the Cochrane Risk of Bias in Non‐Randomised Studies of Interventions for non‐randomised studies tool.ResultsA total of 60 studies were identified describing 525 patients. The majority of studies were either retrospective non‐randomised comparative or case series/reports of poor quality. The vast majority of studies were focussed on prostate cancer after renal transplantation. Overall, 410 (78%) patients underwent surgery, 93 (18%) patients underwent radiation therapy or brachytherapy, one patient underwent focal therapy (high‐intensity frequency ultrasound) and 21 patients were placed on active surveillance. The mean age was 61 years old, the mean PSA level at diagnosis was 9.6 ng/mL and the mean follow‐up time was 31 months. The majority of patients had low‐risk disease with 261 patients having Gleason 6 prostate cancer (50%), followed by 220 Gleason 7 patients (42%). All prostate cancer mortality cases were in high‐risk prostate cancer (≥Gleason 8). The cancer‐specific survival results were similar between surgery and radiotherapy at 1 and 3 years.ConclusionLocalised prostate cancer treatment in renal transplant patients should be risk stratified. Surgery and radiation treatment for localised prostate cancer in renal transplant patients appear equally efficacious. Given the limitations of this study, future research should concentrate on developing a multicentre RCT with long‐term registry follow‐up.

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Changing survival of people with myeloma and end stage kidney disease: A cohort study using Australian and New Zealand dialysis and transplant registry 1963–2013

Cited by 7 publications

References 27 publications

The incidence of cancer recurrence and new cancer following commencement of dialysis

The incidence of cancer recurrence and new cancer following commencement of dialysis

Family-centered shared decision-making in choosing modalities for renal replacement therapy in a pediatric patient with malignant disease

The role of localised prostate cancer treatment in renal transplant patients: A systematic review

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