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Hashimoto, Yasunobu; Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Kobayashi, Hirohito; Omae, Kenji; Yoshida, Kazuhiko; Tanabe, Kazunari
International journal of clinical oncology, 10/2015, Letnik: 20, Številka: 5Journal Article
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.
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