Real-world survival after colorectal surgery for malignancy in Korean patients with chronic kidney disease: an analysis of Korean healthcare big data, 2002-2019.

Autor:	Song I; Division of Colorectal Surgery, Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea., Nam H; RexSoft Corporation, Seoul, Korea., Lee B; RexSoft Corporation, Seoul, Korea.; Institute of Health and Environment, Seoul National University, Seoul, Korea., Park BK; Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea., Kim JK; Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea., Ryoo SB; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Park KJ; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea., Han EC; Division of Colorectal Surgery, Department of Surgery, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea.
Jazyk:	angličtina
Zdroj:	Annals of surgical treatment and research [Ann Surg Treat Res] 2023 Nov; Vol. 105 (5), pp. 281-289. Date of Electronic Publication: 2023 Oct 31.
DOI:	10.4174/astr.2023.105.5.281
Abstrakt:	Purpose: Globally, chronic kidney disease (CKD) is common and has been associated with an increased risk of colorectal cancer (CRC). There is a dearth of literature on the real-world morbidity and mortality associated with CKD comorbid with CRC. This study was performed to evaluate real-world survival outcomes of colorectal malignancy in Korean CKD patients. Methods: The National Health Insurance Service of Korea provided data on patients who underwent surgical resection among patients diagnosed with CRC from 2002 to 2019. Results: A total of 219,550 patients were included: 6,181 patients with underlying CKD and 213,369 patients without it. Each morbidity was significantly higher in the CKD-CRC group, and the postoperative mortality rates for the 30-day (3.11% vs. 1.78%, P < 0.001), 60-day (5.95% vs. 3.83%, P < 0.001), and 90-day mortality rate (8.12% vs. 5.32%, P < 0.001) were significantly higher in the CKD group. The median survival time (MST, year) was significantly lower in the CKD-CRC group (5.63; interquartile range [IQR], 5.26-5.91) than in the non-CKD-CRC group (8.71; IQR, 8.37-8.93). MST was significantly lower among CKD patients who received chemotherapy after adjustment by multivariate analysis (adjusted hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.37-1.49; P < 0.001]). Subgroup analysis showed that in the CKD-CRC group, MST was lower in patients who received dialysis than in those who did not, even after multivariate analysis (adjusted HR, 2.38; 95% CI, 2.20-2.58; P < 0.001). Conclusion: Prevention of CKD-to-end-stage renal disease progression should be adopted as a strategy to increase postoperative survival, along with active surveillance and cancer treatment. Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported. (Copyright © 2023, the Korean Surgical Society.)
Databáze:	MEDLINE
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