{"title":"Postoperative outcomes of pulmonary resection in patients with non small-cell lung cancer with chronic kidney disease: a retrospective study.","authors":"Yoshihito Iijima, Takaki Mizoguchi, Masahito Ishikawa, Shun Iwai, Nozomu Motono, Hidetaka Uramoto","doi":"10.1007/s00595-025-03135-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of chronic kidney disease (CKD) on perioperative and long-term outcomes of pulmonary resection in patients with lung cancer.</p><p><strong>Methods: </strong>Data from 331 patients who underwent pulmonary surgery for non-small-cell Lung cancer associated with CKD between 2016 and 2020 were analyzed. Patients were categorized based on preoperative reduced renal function (estimated glomerular filtration rate [eGFR] < 45 mL/min/1.73m<sup>2</sup> [CKD grade ≥ G3b]). Patients with (n = 20) and without (n = 311) CKD were compared based on their clinicopathological characteristics and outcomes.</p><p><strong>Results: </strong>Grades ≥ 2 and ≥ 3 postoperative pulmonary complications (PPCs) in the Clavien-Dindo classification and postoperative air leaks were common in the CKD group (p = 0.015, 0.005, and 0.025, respectively). The duration of drainage and hospital stay was long (p = 0.003, and p = 0.040, respectively). Kaplan-Meier curves showed a poor prognosis with regard to the overall survival (p = 0.022) and disease-free survival (p = 0.018) in the CKD group. A multivariate analysis confirmed that CKD with an eGFR < 45 mL/min/1.73 m<sup>2</sup> was a significant risk factor for grade ≥ 3 PPCs (p = 0.037).</p><p><strong>Conclusions: </strong>CKD with an eGFR < 45 mL/min/1.73 m<sup>2</sup> involves various perioperative risks; therefore, care must be taken in intraoperative and perioperative management, and long-term collaboration with a nephrologist even before surgery is necessary.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-025-03135-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To investigate the impact of chronic kidney disease (CKD) on perioperative and long-term outcomes of pulmonary resection in patients with lung cancer.
Methods: Data from 331 patients who underwent pulmonary surgery for non-small-cell Lung cancer associated with CKD between 2016 and 2020 were analyzed. Patients were categorized based on preoperative reduced renal function (estimated glomerular filtration rate [eGFR] < 45 mL/min/1.73m2 [CKD grade ≥ G3b]). Patients with (n = 20) and without (n = 311) CKD were compared based on their clinicopathological characteristics and outcomes.
Results: Grades ≥ 2 and ≥ 3 postoperative pulmonary complications (PPCs) in the Clavien-Dindo classification and postoperative air leaks were common in the CKD group (p = 0.015, 0.005, and 0.025, respectively). The duration of drainage and hospital stay was long (p = 0.003, and p = 0.040, respectively). Kaplan-Meier curves showed a poor prognosis with regard to the overall survival (p = 0.022) and disease-free survival (p = 0.018) in the CKD group. A multivariate analysis confirmed that CKD with an eGFR < 45 mL/min/1.73 m2 was a significant risk factor for grade ≥ 3 PPCs (p = 0.037).
Conclusions: CKD with an eGFR < 45 mL/min/1.73 m2 involves various perioperative risks; therefore, care must be taken in intraoperative and perioperative management, and long-term collaboration with a nephrologist even before surgery is necessary.
期刊介绍:
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.