Open AccessLong‐Term Outcomes of Pulmonary Resection for Lung Cancer Patients with Chronic Kidney Disease
Author(s) -
Yamamoto Yoko,
Kanzaki Ryu,
Kanou Takashi,
Ose Naoko,
Funaki Soichiro,
Minami Masato,
Shintani Yasushi
Publication year - 2019
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-019-05143-3
Subject(s) - medicine , kidney disease , comorbidity , cardiothoracic surgery , lung cancer , renal function , pulmonary function testing , abdominal surgery , cardiac surgery , cancer , renal cell carcinoma , kidney cancer , survival rate , surgery
Background The survival outcome in lung cancer patients with chronic kidney disease (CKD) has not been well evaluated. The aim of this study was to evaluate the survival outcomes following non‐small cell lung cancer (NSCLC) surgery in patients with CKD as a preoperative comorbidity. Methods Among 671 patients who underwent surgery for NSCLC between 2007 and 2014 at our hospital, 55 (8%) had CKD and we retrospectively analyzed the survival outcomes of these patients. Results Most patients with CKD were elderly and male. Patients with CKD had a higher frequency of smoking habit, cardiovascular disease, and pulmonary diseases, and a notably lower pulmonary function, resulting in receiving limited pulmonary resection. There were no marked differences in the frequency of surgical complications between patients with and without CKD ( p = 0.16). Squamous cell carcinoma was more frequently diagnosed in patients with CKD than in those without it. The 5‐year disease‐free survival rates in patients with and without CKD were 60.0% and 69.7% ( p = 0.06), respectively, and the 5‐year overall survival rates were 68.9% and 80.0%, respectively, showing significant differences ( p = 0.01). The rate of receiving supportive care was higher in patients with CKD when recurrence observed. Conclusion CKD is associated with a poorer overall survival in patients who undergo lung cancer resection for recurrent disease. As patients with CKD tend to have a poor respiratory function, thoracic surgeons should carefully select the resection type to balance the therapeutic benefit and invasiveness.