Acta Medica Okayama 71巻 4号
2017-08 発行

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

Otani, Yusuke Department of Gastroenterological Surgery, Kochi Health Sciences Center
Okabayashi, Takehiro Department of Gastroenterological Surgery, Kochi Health Sciences Center
Shima, Yasuo Department of Gastroenterological Surgery, Kochi Health Sciences Center
Shibuya, Yuichi Department of Gastroenterological Surgery, Kochi Health Sciences Center
Ozaki, Kazuhide Department of Gastroenterological Surgery, Kochi Health Sciences Center
Iwata, Jun Department of Diagnostic Pathology, Kochi Health Sciences Center
Morita, Sojiro Department of Radiology, Kochi Health Sciences Center
Iiyama, Tatsuo Department of Gastroenterological Surgery, Kochi Health Sciences Center
Publication Date
2017-08
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.
Document Type
Original Article
Keywords
gastric cancer
surgery
hemodialysis
outcomes
prognosis
ESRD
Link to PubMed
Thumnail 71_4_333.pdf 2.06 MB