Pulmonary resection for lung cancer patients on chronic hemodialysis: clinical outcome and long-term results after operation☆

The purpose of this study was to investigate the clinical characteristics of chronic hemodialysis (HD) patients with lung cancer who underwent pulmonary resection at the authors' hospital. Subjects were 24 chronic HD patients (1.1%) from among 2178 patients who underwent pulmonary resection for lung cancer at our hospital between December 1994 and March 2009. Subjects included 20 males (83.3%), and mean age was 65.9 years. Twenty-two patients underwent lobectomy, one underwent a wedge resection and one underwent a segmentectomy. Histological diagnoses included squamous cell carcinoma in 12 patients, adenocarcinoma in nine, small cell carcinoma in two and adenosquamous carcinoma in one. The distribution of pathological staging was IA in nine cases, IB in five, IIB in five, IIIA in three, and IIIB in two. There was no operative mortality, and the overall morbidity rate was 58.3%. Disease-free interval was six to 102 months with a median of 54 months, and the five-year survival rate was 43.0%. Cases of pulmonary resection for lung cancer in chronic HD patients were investigated. There were no operative deaths or deaths in hospital, but three patients had serious complications. These data indicate that surgery can be performed safely with appropriate HD and general management in the perioperative period.