Korean J Thorac Cardiovasc Surg.  2015 Jun;48(3):193-198. 10.5090/kjtcs.2015.48.3.193.

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

• Park BJ
• Shin S
• Kim HK
• Choi YS
• Kim J
• Shim YM

• KMID: 2382255
• DOI: http://doi.org/10.5090/kjtcs.2015.48.3.193

Abstract

BACKGROUND
Patients 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).
METHODS
Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses.
RESULTS
The 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.
CONCLUSION
Surgery 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.

Keyword

Dialysis; Renal dialysis; Pulmonary surgical procedures; Thoracic surgery; Lung neoplasms

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Cerebral Infarction
Delirium
Dialysis
Follow-Up Studies
Hemorrhage
Hospital Mortality
Humans
Lung Neoplasms
Pneumonia
Prognosis
Pulmonary Edema
Pulmonary Surgical Procedures
Recurrence
Renal Dialysis*
Renal Insufficiency, Chronic*
Retrospective Studies
Thoracic Surgery
Thoracic Surgical Procedures