CLINICAL RESEARCH
Appraisal of lung cancer survival in patients with end-stage renal disease
 
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1
Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, ChiaYi, Taiwan
2
Department of Radiation Oncology, Chang Gung Memorial Hospital, Taiwan and Chang Gung University, College of Medicine, ChiaYi, Taiwan
3
Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, ChiaYi, Taiwan
4
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, ChiaYi, Taiwan
5
Department of Respiratory Therapy, Chang Gung University, Taiwan
Submission date: 2019-03-17
Final revision date: 2019-07-02
Acceptance date: 2019-07-04
Online publication date: 2019-07-22
 
 
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ABSTRACT
Introduction:
The survival outcome of lung cancer patients with end-stage renal disease has been poorly studied in the literature. In this study, we evaluated the effect of end-stage renal disease on lung cancer survival.

Material and methods:
A retrospective, multicenter, matched-cohort study of lung cancer patients with end-stage renal disease under renal replacement therapy (WITH-ESRD) and without end-stage renal disease (WITHOUT-ESRD) was performed. One WITH-ESRD patient was matched to four WITHOUT-ESRD patients.

Results:
Baseline clinical characteristics did not differ statistically significantly after matching between the WITH-ESRD and WITHOUT-ESRD groups. WITH-ESRD included 133 patients and WITHOUT-ESRD included 532 patients. Kaplan-Meier survival analysis demonstrated no significant difference in median overall survival between WITH-ESRD patients and WITHOUT-ESRD patients (7.36 months versus 12.25 months, respectively, p = 0.133). Lung cancer WITH-ESRD patients receiving medical treatment had a median overall survival of 5.98 months (95% CI: 4.34–11.76) compared to 14.13 months (95% CI: 11.30–16.43) for WITHOUT-ESRD patients, p = 0.019. Although patients receiving surgical treatment compared to those receiving medical treatment had an improvement of survival by 46% (HR = 0.54, 95% CI: 0.19–1.53, p = 0.243), the difference did not reach statistical significance. Cox regression analysis revealed that male gender and stage IIIA-IV were independent factors associated with poor outcome for WITH-ESRD patients.

Conclusions:
In our limited experience, the survival for lung cancer with ESRD is not inferior to lung cancer patients without ESRD. The reasons for poor survival for the WITH-ESRD medical treatment group and late diagnosis despite frequent medical visits merit further investigation.

eISSN:1896-9151
ISSN:1734-1922