Preoperative renal dysfunction and long-term survival after surgery for non–small cell lung cancer
| Autor: | Yasushi Shintani, Hiroshi Date, Tomohiro Murakawa, Ichiro Yoshino, Shun-ichi Watanabe, Mitsutaka Kadokura, Etsuo Miyaoka, Shunsuke Endo, Tomohito Saito, Jiro Okami, Masayuki Chida, Hisao Asamura, Shinichi Toyooka, Hiroyuki Ito, Takashi Ohtsuka, Ryoichi Nakanishi, Takeshi Mori |
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| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Lung Neoplasms Renal function Disease End stage renal disease chemistry.chemical_compound Renal Dialysis Risk Factors Carcinoma Non-Small-Cell Lung medicine Humans Renal Insufficiency Chronic Lung cancer Retrospective Studies Lung cancer surgery Creatinine business.industry Acute kidney injury medicine.disease Surgery chemistry Kidney Failure Chronic Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 164:227-239.e6 |
| ISSN: | 0022-5223 |
| Popis: | To investigate the association of preoperative renal dysfunction and long-term outcomes following lung cancer surgery.Using the Japanese Lung Cancer Registry data, we retrospectively examined 16,377 patients who underwent surgery for non-small cell lung cancer during 2010. Patients' renal function status was categorized as follows: serum creatinine1.5 mg/dL (control, n = 16,169), serum creatinine ≥1.5 mg/dL with no dialysis (nondialysis-dependent chronic kidney disease, n = 113), and dialysis-dependent end-stage renal disease (n = 95). The association of patients' characteristics with overall survival was evaluated using multivariate Cox proportional hazard model.The 5-year overall survival rates in patients with dialysis-dependent end-stage renal disease and with nondialysis-dependent chronic kidney disease were significantly worse than that in the control group (52.9% and 57.5% vs 78.0%; P .001 for both comparisons), but were comparable to the reported 5-year overall survival rates in the natural history of end-stage renal disease (∼60%) and moderate to severe chronic kidney disease (∼50%). Cancer causes not related to lung cancer accounted for 62.2% of deaths in dialysis-dependent end-stage renal disease, which was more frequent than that in the control group (P = .002). Dialysis-dependent end-stage renal disease and nondialysis-dependent chronic kidney disease were independent risk factors for overall survival after lung cancer surgery (hazard ratio, 2.05 [P .001] and hazard ratio, 2.04 [P = .001], respectively).Preoperative renal dysfunction may be adversely associated with overall survival after lung cancer surgery. Our findings could aid patients to set proper expectation of the risks and benefits about surgery for lung cancer. |
| Databáze: | OpenAIRE |
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