title: Comparison of prognosis between patients with renal cell carcinoma on hemodialysis and those with renal cell carcinoma in the general population.
abstract: OBJECTIVE
  We compared the clinical features and prognosis of renal cell carcinoma (RCC) between patients on hemodialysis (RCC-HD) and those in the general population (RCC-general).
  
  
  METHODS
  We included a total of 1,794 patients who underwent surgery (RCC-HD, 408; RCC-general, 1,386) and analyzed the clinical characteristics and oncological outcomes using a stage-for-stage analysis between the two groups.
  
  
  RESULTS
  In the RCC-HD group, the mean duration of dialysis before surgery was 120 months. Compared to the RCC-general group, the RCC-HD group tended to be younger (55 vs. 60 years, p < 0.0001) and more predominately male (84 % vs. 70 %, p < 0.0001), and the tumor size was smaller in this group (39 vs. 49 mm, p < 0.0001). The pathological characteristics of the RCC-HD group included a higher frequency of papillary tumors (22 % vs. 5 %, p < 0.0001) and stage I tumors (82 % vs. 68 %, p < 0.0001). During the follow-up period, 39 of patients (10 %) in the RCC-HD group and 193 patients (14 %) in the RCC-general group died of cancer. The patients on hemodialysis had better cancer-specific survival (CSS) than their counterparts (p = 0.0292) in the univariable analysis, but no significance was found in the multivariable analysis. In the stage-for-stage analysis, the 5-year CSS was similar between the two groups for each stage.
  
  
  CONCLUSIONS
  CSS appeared to be better in the RCC-HD group than in the RCC-general group, which may be associated with the higher incidence of stage I disease in the RCC-HD group. The comparable CSS between the groups in the stage-for-stage analysis supports this finding.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. t.takagi1192@gmail.com.
authors.forename: Toshio
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Iizuka
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Omae
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D007680:Kidney Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D016019:Survival Analysis
keywords: Hemodialysis; Kidney neoplasm; Nephrectomy; Prognosis