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Original Articles: General Thoracic

Clinical Outcome After Pulmonary Resection for Lung Cancer Patients on Hemodialysis

Department of Thoracic, Breast, Endocrine, and Pediatric Surgery, Fukuoka University Hospital, Fukuoka, Japan

Accepted for publication August 6, 2009.

^_* Address correspondence to Dr Obuchi, Jonan-ku, Nanakuma, 7 chome, 45-1, Fukuoka, 814-0180, Japan (Email: tobuchi{at}fukuoka-u.ac.jp).

Background: The number of operations for patients with malignant tumors receiving long-term hemodialysis has been increasing; however, there are only few reports about pulmonary resection for the patients with lung cancer.

Methods: Between 1995 and 2009, 11 hemodialysis patients (6 men, 5 women; mean age, 66.4 years) with non-small cell lung cancer underwent pulmonary resection at our institution. We retrospectively evaluated their postoperative clinical outcomes and long-term results.

Results: The underlying kidney conditions included nephrosclerosis in 3, diabetic nephropathy in 3, glomerulonephritis in 1, and polycystic kidney in 1; 3 patients had undergone nephrectomy. The median duration of hemodialysis preoperatively was 5.0 years. Three patients had been treated for previous carcinoma. The histopathologic diagnoses were adenocarcinoma in 9 patients and squamous cell carcinoma in 2. Procedures included lobectomy in 9, pneumonectomy in 1, and wedge resection in 1. There were no in-hospital deaths. Postoperative morbidity included 2 cases of pneumonia and 1 of chylothorax. At the time of our investigation, 6 patients were dead; 2 of cancer and 4 of noncancer causes. The overall 5-year survival rate of 11 patients was 28.0%.

Conclusions: Hemodialysis is not a contraindication to lung resection, despite the high morbidity rate. Surgical treatments, including lobectomy, remain one of effective treatments for patients on hemodialysis with lung cancer.

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