Clinical outcome after pulmonary resection for lung cancer patients on hemodialysis.
BACKGROUND
The number of operations for patients with malignant tumors receiving long-term hemodialysis has been increasing; however, there are only few reports about pulmonary resection for the patients with lung cancer.


METHODS
Between 1995 and 2009, 11 hemodialysis patients (6 men, 5 women; mean age, 66.4 years) with non-small cell lung cancer underwent pulmonary resection at our institution. We retrospectively evaluated their postoperative clinical outcomes and long-term results.


RESULTS
The underlying kidney conditions included nephrosclerosis in 3, diabetic nephropathy in 3, glomerulonephritis in 1, and polycystic kidney in 1; 3 patients had undergone nephrectomy. The median duration of hemodialysis preoperatively was 5.0 years. Three patients had been treated for previous carcinoma. The histopathologic diagnoses were adenocarcinoma in 9 patients and squamous cell carcinoma in 2. Procedures included lobectomy in 9, pneumonectomy in 1, and wedge resection in 1. There were no in-hospital deaths. Postoperative morbidity included 2 cases of pneumonia and 1 of chylothorax. At the time of our investigation, 6 patients were dead; 2 of cancer and 4 of noncancer causes. The overall 5-year survival rate of 11 patients was 28.0%.


CONCLUSIONS
Hemodialysis is not a contraindication to lung resection, despite the high morbidity rate. Surgical treatments, including lobectomy, remain one of effective treatments for patients on hemodialysis with lung cancer.
Obuchi
Toshiro
T
Department of Thoracic, Breast, Endocrine, and Pediatric Surgery, Fukuoka University Hospital, Fukuoka, Japan. tobuchi@fukuoka-u.ac.jp
Hamanaka
Wakako
W
Yoshida
Yasuhiro
Y
Yanagisawa
Jun
J
Hamatake
Daisuke
D
Shiraishi
Takeshi
T
Iwasaki
Akinori
A
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome