Is chronic kidney disease an adverse factor in lung cancer clinical outcome? A propensity score matching study

Abstract

BackgroundComorbidity has a great impact on lung cancer survival. Renal function status may affect treatment decisions and drug toxicity. The survival outcome in lung cancer patients with coexisting chronic kidney disease (CKD) has not been fully evaluated. We hypothesized that CKD is an independent risk factor for mortality in patients with lung cancer.MethodsA retrospective, propensity‐matched study of 434 patients diagnosed between June 2004 and May 2012 was conducted. CKD was defined as estimated glomerular filtration rate <60 mL/minute. Lung cancer and coexisting CKD patients were matched 1:1 to patients with lung cancer without CKD.ResultsAge, gender, smoking status, histology, and lung cancer stage were not statistically significantly different between the CKD and non‐CKD groups. Kaplan–Meier survival analysis demonstrated a median survival of 7.26 months (95% confidence interval [CI] 6.06–8.46) in the CKD group compared with 7.82 months (95% CI 6.33–9.30) in the non‐CKD group (P = 0.41). Lung cancer stage‐specific survival is not affected by CKD. Although lung cancer patients with CKD presented with an increased risk of death of 6%, this result was not statistically significant (hazard ratio 1.06, 95% CI 0.93–1.22; P = 0.41).ConclusionAccording to our limited experience, CKD is not an independent risk factor for survival in lung cancer patients. Clinicians should not be discouraged to treat lung cancer patients with CKD.

Lung cancer outcome in the setting of chronic kidney disease: Does the glomerular filtration estimation formula matter?

“…In a previous retrospective report using the CG formula, Lu et al . found similar rates of survival between CKD and non‐CKD patients . Xie et al .…”

“…Lu et al . found a 6% increased risk of death for CKD patients; however, this result was not statistically significant (HR 1.06, 95% CI 0.93–1.22; P = 0.41) . In a recent population‐based cohort study in Taiwan of lung cancer patients with coexisting CKD, Wei et al .…”

“…Chronic kidney disease (CKD) markers account for 4.4% of overall cancer incidence and are responsible for 3.3 years of life lost . However, studies of survival outcomes of lung cancer patients with deteriorated renal function have shown conflicting results in the literature . In this study, we first evaluated survival outcomes of patients with lung cancer and coexisting CKD using a propensity‐matched study using two commonly used formulas for estimating glomerular filtration rate.…”

“…3 However, studies of survival outcomes of lung cancer patients with deteriorated renal function have shown conflicting results in the literature. [4][5][6][7][8] In this study, we first evaluated survival outcomes of patients with lung cancer and coexisting CKD using a propensitymatched study using two commonly used formulas for estimating glomerular filtration rate. Second, we tested the hypothesis that CKD is an independent risk factor for mortality in patients with lung cancer.…”

Impact of cancers on the kidney function and structure; an ignored entity

“…In addition, it has been confirmed that lung cancer and CKD may have a similar course and survival in comparison with the patients with lung cancer without CKD, which it means that these two diseases could receive the same benefit from treatment (24). However, it has also approved that CKD could not be an independent risk factor for survival in patients with lung cancer (25). Moreover, progressive renal failure was observed in patients with lung adenocarcinoma (26).…”