Outcome of renal cell carcinoma in patients on dialysis compared to non-dialysis patients.

Abstract

PURPOSE:

To investigate the impact of hemodialysis on survival in renal cell carcinoma (RCC) patients.

METHODS:

We studied 388 patients who underwent radical or partial nephrectomy for RCC at Toranomon Hospital from 2005 to 2013. Survival curves were drawn according to the Kaplan-Meier method and compared with the log-rank test. Multivariate analysis was performed using the Cox proportional hazards regression model to assess the prognostic influence of hemodialysis on cancer-specific survival.

RESULT:

Of the 388 patients, 66 were on hemodialysis and 322 were not on dialysis. In the hemodialysis patients, incidental diagnosis of RCC was less frequent than in the non-dialysis patients. In addition, RCC was more likely to be multicentric (41% vs 1.2%), bilateral (14% vs 0.6%), and papillary (18% vs 7%) in hemodialysis patients. Moreover, tumors were smaller, the stage was lower, and the Fuhrman nuclear grade was higher in the patients on hemodialysis. The 5-year cancer-specific survival rate was 82.8% for hemodialysis patients and 93.5% for nondialysis patients. Multivariate analysis indicated that hemodialysis, stage, and Fuhrman nuclear grade were independent prognostic factors for RCC.

CONCLUSIONS:

This study suggested that hemodialysis was an independent prognostic factor for cancer-specific survival in RCC patients, along with the tumor stage and Fuhrman nuclear grade.

• Authors: Noriko Hayami, Yoshifumi Ubara, Toshikazu Okaneya, Takeshi Fujii, Yoji Nagashima, Kenichi Ohashi
• Journal: Seminars in dialysis (Semin Dial) Vol. 33 Issue 4 Pg. 316-321 (07 2020) ISSN: 1525-139X [Electronic] United States
• PMID: 32557805 (Publication Type: Journal Article)
• Copyright: © 2020 Wiley Periodicals LLC.

Topics

• Carcinoma, Renal Cell (pathology, surgery)
• Humans
• Kidney Neoplasms (therapy)
• Neoplasm Staging
• Nephrectomy
• Prognosis
• Renal Dialysis
• Retrospective Studies