Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
To compare characteristics and prognosis unilateral and bilateral renal cell carcinoma (RCC) in hemodialysis (HD) patients.
Overall 246 HD patients who had undergone a radical nephrectomy for RCC were enrolled in this study. Unilateral RCC occurred in 201 patients, synchronous bilateral RCC in 15 and metachronous bilateral RCC in 30. Cancer-specific survival (CSS) was accessed by the Kaplan-Meier method.
Five-year CSS was not significantly different between the two groups (unilateral, 90%; bilateral, 90%; P = 0.9509). In total 17 of the 201 patients (8.5%) with unilateral occurrence and four of the 45 patients (8.9%) with bilateral occurrence died from kidney cancer during the follow-up period. The presence of acquired cystic disease of kidney (unilateral, 73%; bilateral 91%; P = 0.00319) and the mean duration of HD before surgery (unilateral: 157 ± 91 months, bilateral: 189 ± 83.5, P = 0.0319) were significantly different between the two groups. There were more multifocal tumors in bilateral than in unilateral occurrence (bilateral: 74%, unilateral: 30%, P < 0.0001). There were significant differences in CSS according to HD duration before surgery (5-year CSS >180 months 82%, ≤180 months 95%; P = 0.0004), tumor grade (G1 100%, G2 90%, G3 38%; P < 0.0001), and tumor size (>4 cm 75%, ≤ 4 cm 98%; P < 0.0001).
The type of occurrence of RCC, unilateral or bilateral, in HD patients does not appear to influence CSS. Patients with a longer duration of HD have to be followed up rigorously because they tend to have poor cancer prognosis.
Written by:
Takagi T, Kondo T, Izuka J, Kobayashi H, Tomita E, Hashimoto Y, Tanabe K. Are you the author?
Reference: Int J Urol. 2011 Sep 14. Epub ahead of print.
doi: 10.1111/j.1442-2042.2011.02852.x
PubMed Abstract
PMID: 21917022
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