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Lung cancer surgery for patients on hemodialysis: A decade of experience at multicenter institutions.

Abstract

BACKGROUND

The clinical outcome of patients receiving hemodialysis (HD) has not yet been clarified in lung cancer surgery. The aims of this study were to assess the clinical features, outcomes and main cause of death following lung cancer surgery in HD patients and to evaluate the risk factors of postoperative complications.

METHODS

We identified 39 patients receiving HD who underwent lung cancer surgery in 9 institutions under the Thoracic Surgery Study Group of Osaka University between 2007 and 2016. We retrospectively analyzed the surgical outcomes of these patients.

RESULTS

Most patients were male and had a smoking habit. Diabetes mellitus was the most common cause of primary renal disease. Lobectomy with systemic lymph node dissection was performed in 16 patients, and an extended operation was performed in 6 patients. The most patients diagnosed with pStage IA (69.2%). The overall complication and mortality rates were 30.8% and 7.7%, respectively. Pneumonia was the most frequently observed complication. Extended operation was significantly associated with complications (p=0.04). The five-year overall survival rate was 57.9%, and the most common cause of death was a disease other than primary lung cancer that was related to HD.

CONCLUSIONS

Lung cancer surgery for HD patients provides favorable long-term outcomes despite higher postoperative mortality and morbidity rates. As an extended operation is significantly associated with postoperative complications, thoracic surgeons should carefully select the type of resection based on a balance between the therapeutic benefit and invasiveness in these patients.

Authors+Show Affiliations

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: rkanzaki@tj8.so-net.ne.jp.Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.Department of Thoracic Surgery, Osaka General Medical Center, Osaka, Japan.Department of General Thoracic Surgery, Sakai City Medical Center, Osaka, Japan.Department of General Thoracic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.Department of General Thoracic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan.Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan.Department of Thoracic Surgery, Suita Municipal Hospital, Osaka, Japan.Department of Thoracic Surgery, Kindai University Nara Hospital, Nara, Japan.Department of Thoracic Surgery, Yao Municipal Hospital, Osaka, Japan.Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31962110

Citation

Yamamoto, Yoko, et al. "Lung Cancer Surgery for Patients On Hemodialysis: a Decade of Experience at Multicenter Institutions." The Annals of Thoracic Surgery, 2020.
Yamamoto Y, Kanzaki R, Ose N, et al. Lung cancer surgery for patients on hemodialysis: A decade of experience at multicenter institutions. Ann Thorac Surg. 2020.
Yamamoto, Y., Kanzaki, R., Ose, N., Funakoshi, Y., Ikeda, N., Takami, K., ... Shintani, Y. (2020). Lung cancer surgery for patients on hemodialysis: A decade of experience at multicenter institutions. The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2019.11.044.
Yamamoto Y, et al. Lung Cancer Surgery for Patients On Hemodialysis: a Decade of Experience at Multicenter Institutions. Ann Thorac Surg. 2020 Jan 18; PubMed PMID: 31962110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung cancer surgery for patients on hemodialysis: A decade of experience at multicenter institutions. AU - Yamamoto,Yoko, AU - Kanzaki,Ryu, AU - Ose,Naoko, AU - Funakoshi,Yasunobu, AU - Ikeda,Naoki, AU - Takami,Koji, AU - Iwasaki,Teruo, AU - Iwazawa,Takashi, AU - Yokouchi,Hideoki, AU - Shiono,Hiroyuki, AU - Kodama,Ken, AU - Shintani,Yasushi, AU - ,, Y1 - 2020/01/18/ PY - 2019/05/20/received PY - 2019/10/31/revised PY - 2019/11/19/accepted PY - 2020/1/22/entrez PY - 2020/1/22/pubmed PY - 2020/1/22/medline KW - hemodialysis KW - lung cancer KW - surgery JF - The Annals of thoracic surgery JO - Ann. Thorac. Surg. N2 - BACKGROUND: The clinical outcome of patients receiving hemodialysis (HD) has not yet been clarified in lung cancer surgery. The aims of this study were to assess the clinical features, outcomes and main cause of death following lung cancer surgery in HD patients and to evaluate the risk factors of postoperative complications. METHODS: We identified 39 patients receiving HD who underwent lung cancer surgery in 9 institutions under the Thoracic Surgery Study Group of Osaka University between 2007 and 2016. We retrospectively analyzed the surgical outcomes of these patients. RESULTS: Most patients were male and had a smoking habit. Diabetes mellitus was the most common cause of primary renal disease. Lobectomy with systemic lymph node dissection was performed in 16 patients, and an extended operation was performed in 6 patients. The most patients diagnosed with pStage IA (69.2%). The overall complication and mortality rates were 30.8% and 7.7%, respectively. Pneumonia was the most frequently observed complication. Extended operation was significantly associated with complications (p=0.04). The five-year overall survival rate was 57.9%, and the most common cause of death was a disease other than primary lung cancer that was related to HD. CONCLUSIONS: Lung cancer surgery for HD patients provides favorable long-term outcomes despite higher postoperative mortality and morbidity rates. As an extended operation is significantly associated with postoperative complications, thoracic surgeons should carefully select the type of resection based on a balance between the therapeutic benefit and invasiveness in these patients. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/31962110/Lung_cancer_surgery_for_patients_on_hemodialysis:_A_decade_of_experience_at_multicenter_institutions L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(20)30033-3 DB - PRIME DP - Unbound Medicine ER -