The Outcome of Lung Cancer Surgery in Patients on Chronic Hemodialysis: A Multicenter Study

Background The end-stage renal disease is arising worldwide, but there are few reports about pulmonary resection in hemodialysis patients with lung cancer. The objective of the authors is to assess lung cancer surgery outcomes in patients undergoing hemodialisys, to identify the risk factors for morbidity, mortality and overall survival. Methods Clinical records data of 19 hemodialysis patients undergoing curative surgery for lung cancer in 3 centers between 2001 and 2021 were retrospectively collected and analyzed. There were considered pre-operative and perioperative variables and their relationship with morbidity, mortality and survival. Results The complication rate was 84%, with a mortality rate of 5%. The most common complication was bleeding. Heavier smoking history was associated to higher risk of developing complications. Also transfusions were associated with complications. The 5-years overall survival (OS) rate was 29%, while the 5-years Disease free survival (DFS) rate was 62%. OS was correlated with age and clinical stage. Most patients showed non cancer-related deaths. Conclusions In conclusion, although the mortality is remarkable in patients in hemodialisys, the data about OS and DFS make us believe that lung surgery may be still a therapeutic option if patients are properly selected and careful perioperative management is performed.