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P1.07 - Poster Session 1 - Surgery (ID 184)
- Event: WCLC 2013
- Type: Poster Session
- Track: Surgery
- Presentations: 1
- Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level
P1.07-006 - Lung cancer resection in patients with chronic renal failure on hemodialysis (ID 2104)
09:30 - 16:30 | Author(s): Y. Kato
The number of patients with malignant tumors receiving long-term hemodialysis (HD) has been increasing. Patients on HD who undergo surgery represent a high-risk group requiring careful perioperative management to avoid electrolyte imbalance and hemodynamic instability. This retrospective study analyzed the postoperative outcome in terms of complications and survival of a group of patients on HD who underwent pulmonary resection for non-small cell lung cancer.
Between January 1995 and March 2013, 10 patients (7 men, 3 women; median age, 71.5 years) with non-small cell lung cancer who were also receiving HD underwent radical pulmonary resection by open thoracotomy or video-assisted thoracic surgery at Tokyo Medical University Hospital. We retrospectively evaluated their postoperative clinical outcomes and survival results. Most patients had comorbidities, including cardiovascular disease (5), diabetes (3), and brain infarction (1). The distribution of clinical staging was IA in 2 cases, IB in 5, IIB in 1, and IIIA in 2. Procedures included 8 lobectomies and 2 segmentectomies. We performed 4 systematic lymph node dissections and 6 selective lymph node dissections.
The median intraoperative time was 215.5 minutes (range, 101-308). The median blood loss was 55 mL (range, 0-478 mL). Blood transfusion was not necessary. There was no intraoperative mortality. There were major perioperative complications in 4 patients, including atrial fibrillation (3), cardiac failure (1), shunt failure (1), and pneumonia (1). The median length of hospital stay was 21 days (range, 11-47). Thoracic drainage removal was at 4.5 postoperative days (range, 3-9). Pathological staging was IA in 3 cases, IB in 2, IIA in 2, IIB in 1, and IIIA in 2. Two cases were upstaged from the preoperative period to the final period. Seven of the 10 patients are currently alive and recurrence-free. Two patients had mediastinal lymph node and lung recurrence. One patient died from mediastinal lymph node recurrence at 8 months after surgery, and the other patient died at 26 months after surgery from malignant lymphoma.
Patients with chronic renal failure on HD who undergo lung resection have a high rate of postoperative complications (40%). Surgical treatment remains one of the effective treatments for patients on HD with lung cancer.