Clinical Outcome After Pulmonary Resection for Lung Cancer Patients on Hemodialysis

Obuchi, Toshiro; Hamanaka, Wakako; Yoshida, Yasuhiro; Yanagisawa, Jun; Hamatake, Daisuke; Shiraishi, Takeshi; Iwasaki, Atsushi

doi:10.1016/j.athoracsur.2009.08.010

Cited by 18 publications

(18 citation statements)

References 10 publications

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“…of ptsSurgical procedureApproachMorbidity (%)Ohta [40]19921PnOpen1 (100)Yamamoto [41]19961LbOpen1 (100)Tsuchida [42]20017LbOpen7 (100)Ciriaco [43]20056*Lb 5, Pn 1, Weg 1Open4 (57)Yajima [44]20051LbOpen1 (100)Obuchi [45]200911Lb 9, Pn 1, Weg 1VATS 4, Open 73 (27)Akiba [46]20102Lb 1, Wed 1VATS0 (0)Takahama [47]201024Lb 22, Sg 1, Weg 1Open13 (59)Matsuoka [48]20135Lb 4, Sg 1VATS2 (40)Caroli [49]20151LbVATS0 (0)Park [50]20157Lb 5, Weg 2VATS 4, Open 33 (42) No number, pts patients, Pn pneumonectomy, Lb lobectomy, Sg segmentectomy, Weg wedge resection*One patient had two operations …”

Section: Resultsmentioning

confidence: 99%

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Recommendations for perioperative management of lung cancer patients with comorbidities

Tsubochi

Shibano

Endo

2017

Gen Thorac Cardiovasc Surg

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ObjectivesTo improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery.MethodsWe reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery. Articles identified by keyword searches were included in the analysis.ResultsSignificant predictive factors for acute exacerbation of idiopathic pulmonary fibrosis were identified. However, no effective perioperative care was identified for prevention of acute exacerbation of interstitial pneumonia. The timing of coronary revascularization and antithrombotic management for cardiovascular diseases are subjects of ongoing research, and acid–base balance is essential in the management of hemodialysis patients with end-stage renal diseases.ConclusionsTo improve surgical outcomes for lung cancer patients, future studies should continue to study optimal perioperative management of comorbidities.

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Section: Resultsmentioning

confidence: 99%

“…Some small studies reported a 5-year overall survival rate of 28–43% [45, 47, 50], while 5-year overall survival after induction of hemodialysis was approximately 41.5–60.8% [36, 37]. Survival is worse for patients with diabetes than for those without diabetes (20.7–34%) [63].…”

Section: Resultsmentioning

confidence: 99%

Recommendations for perioperative management of lung cancer patients with comorbidities

Tsubochi

Shibano

Endo

2017

Gen Thorac Cardiovasc Surg

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“…In this report, the resection rate for WITH-ESRD patient was 14.3%, and it concurred with the previous report. The surgical outcome of lung resection for patients under dialysis reported in several small clinical series demonstrated acceptable surgical risk and long-term outcome [32][33][34][35]. In a series of 24 dialysis patients from Japan (lobectomies: 22, wedge resection: 1 and segmentectomy: 1), 54 months median survival was reported [32].…”

Section: Discussionmentioning

confidence: 99%

Appraisal of lung cancer survival in patients with end-stage renal disease

Chen

Yang

et al. 2019

Arch Med Sci

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Introduction: The survival outcome of lung cancer patients with end-stage renal disease has been poorly studied in the literature. In this study, we evaluated the effect of end-stage renal disease on lung cancer survival. Material and methods: A retrospective, multicenter, matched-cohort study of lung cancer patients with end-stage renal disease under renal replacement therapy (WITH-ESRD) and without end-stage renal disease (WITH-OUT-ESRD) was performed. One WITH-ESRD patient was matched to four WITHOUT-ESRD patients. Results: Baseline clinical characteristics did not differ statistically significantly after matching between the WITH-ESRD and WITHOUT-ESRD groups. WITH-ESRD included 133 patients and WITHOUT-ESRD included 532 patients. Kaplan-Meier survival analysis demonstrated no significant difference in median overall survival between WITH-ESRD patients and WITHOUT-ESRD patients (7.36 months versus 12.25 months, respectively, p = 0.133). Lung cancer WITH-ESRD patients receiving medical treatment had a median overall survival of 5.98 months (95% CI: 4.34-11.76) compared to 14.13 months (95% CI: 11.30-16.43) for WITHOUT-ESRD patients, p = 0.019. Although patients receiving surgical treatment compared to those receiving medical treatment had an improvement of survival by 46% (HR = 0.54, 95% CI: 0.19-1.53, p = 0.243), the difference did not reach statistical significance. Cox regression analysis revealed that male gender and stage IIIA-IV were independent factors associated with poor outcome for WITH-ESRD patients. Conclusions: In our limited experience, the survival for lung cancer with ESRD is not inferior to lung cancer patients without ESRD. The reasons for poor survival for the WITH-ESRD medical treatment group and late diagnosis despite frequent medical visits merit further investigation.

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“…Due to advances in dialysis techniques, the number of patients on long-term dialysis has been increasing [ 1 ]. Moreover, a tendency for lung cancer to be detected earlier in dialysis patients has been reported, since these patients undergo more extensive follow-up and are monitored more closely by their doctors [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

Park

Shin

Kim

et al. 2015

Korean J Thorac Cardiovasc Surg

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BackgroundPatients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD).MethodsBetween 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses.ResultsThe median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease.ConclusionSurgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

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Clinical Outcome After Pulmonary Resection for Lung Cancer Patients on Hemodialysis

Cited by 18 publications

References 10 publications

Recommendations for perioperative management of lung cancer patients with comorbidities

Recommendations for perioperative management of lung cancer patients with comorbidities

Appraisal of lung cancer survival in patients with end-stage renal disease

Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

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