Lung Cancer: Lung Cancer III |

Clinical Course of Lung Cancer in Patients With Chronic Kidney Disease FREE TO VIEW

Yun Su Sim, MD; Tae Rim Shin, MD; DongGyu Kim, MD
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Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea (the Republic of)

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):728A. doi:10.1016/j.chest.2016.08.823
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Patients maintained on dialysis are potentially at increased risk of cancer. However, very few studies have examined the clinical course of patients. We evaluated clinical course of lung cancer in patients with chronic renal disease

METHODS: We retrospectively analyzed the clinical data of 49 patients with chronic kidney disease (CKD) stage 3~5 on diagnosis of lung cancer from January 2008 to May 2015 from five hallym university hospitals. Stage 3 of chronic kidney disease is defined as 30 ≤ glomerular filtration rate (GFR) < 60, 15 ≤ GFR of stage 4 CKD < 30, GFR of stage 5 CKD < 15 or dialysis state. Good prognosis is defined as duration of survival ≥ 12 months.

RESULTS: Male were 41 (84%) and the median age was 73. The median GFR was 30.4 mL/min/1.73m2 and median serum creatinine was 1.68 mg/dL. The proportion of each stage of CKD were three (52%), four (22%), and five (24%). Pathologic types of lung cancer were adenocarcinoma (39%), squamous cell carcinoma (27%), and small cell carcinoma (29%). Stages of non-small cell lung cancer were I (9%), II (11%), III (20%), and IV (60%). patients with small cell lung cancer were limited (79%) and extensive (21%) stages. Treatments for lung cancer with CKD were supportive care (20%), chemotherapy (49%), radiation therapy (18%), and surgery (8%). Duration of survival stage I was 23 months and stage IV was 5 months. Survivals of small cell lung cancer were limited stage (9 months) and extensive stage (6 months). Good prognostic factor of patients with lung cancer and CKD by multivariate analysis was adenocarcinoma (odd ratio 0.167, confidence interval 0.044-0.636, p=0.009)

CONCLUSIONS: Survival of patients with lung cancer and CKD are similar to that of lung cancer patients without CKD. Adenocarcinoma is good prognosis in patients with CKD. Treatment of lung cancer does need to be individualized in the setting of CKD, but, it should not dissuade the clinician from treating the malignancy

CLINICAL IMPLICATIONS: This study presented clinical course of lung cancer in patients with chronic renal disease. This result will guide treatmemt for patients with lung cancer and CKD.

DISCLOSURE: The following authors have nothing to disclose: Yun Su Sim, Tae Rim Shin, DongGyu Kim

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