Safety and Efficacy of the Surgical Management of Hemodialysis Patients with Gastric Cancer

Acta Med Okayama. 2017 Aug;71(4):333-339. doi: 10.18926/AMO/55310.

Abstract

This retrospective study evaluated the short- and long-term outcomes after surgical management for gastric cancer in hemodialysis patients compared to non-dialysis patients. Twelve hemodialysis patients were compared with a propensity score-matched cohort of 39 gastric cancer patients who had not undergone hemodialysis. Short- and long-term outcomes along with scores estimating physiological ability and surgical stress were evaluated in both groups. The incidence of postoperative morbidity according to the Clavien-Dindo classification was higher in the hemodialysis gastric cancer group than in the non-dialysis gastric cancer group. The 5-year overall survival rate in the non-dialysis group was 69.2% after surgical resection for gastric cancer and 22.2% in the hemodialysis group. Patients with preoperative risk scores≥0.48 had significantly poorer survival outcomes compared to those with preoperative risk scores<0.48 (5-year survival rate, 83.3% vs. 39.4%, respectively). Our analyses suggest that hemodialysis patients undergoing surgery for gastric cancer have a significantly poorer postoperative prognosis and an elevated risk of postoperative complications.

Keywords: ESRD; gastric cancer; hemodialysis; outcomes; prognosis; surgery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Renal Dialysis / adverse effects*
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / surgery*
  • Survival Analysis