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.
Keywords: Hemodialysis; Kidney neoplasm; Nephrectomy; Prognosis.