Cancer diagnosis and prognosis after initiation of hemodialysis: multicenter Japan CANcer and DialYsis (J-CANDY) study
Authors: Toriu Naoya , Yamamoto Shinya , Matsubara Takeshi , Kataoka Yuki , Sakai Kaoru , Funakoshi Taro , Horimatsu Takahiro , Tsukamoto Tatsuo , Murakami Naoka , Jhaveri Kenar D , Fukuma Shingo , Terada Tomohiro , Muto Manabu , Fukuhara Shunichi , Yanagita Motoko ,   Onconephrology Consortium in Japan, Nakamura Michio , Shiroshita Kouichi , Shimamoto Mamiko , Moriwaki Toshikazu , Hagiwara Masahiro , Kaneko Shuzo , Yamagata Kunihiro , Kondo Chihiro , Takano Toshimi , Hayami Noriko , Sawa Naoki , Ubara Yoshifumi , Izawa Naoki , Mizukami Takuro , Tsuda Takashi , Sueki Shina , Sakurada Tsutomu , Okano Naohiro , Fukuoka Kazuhito , Kaname Shinya , Taku Keisei , Nishio Haruomi , Mori Noriko , Goto Tomoyuki , Ueda Kosuke , Matsumura Kazuyoshi , Kosuga Kunihiko , Sasada Masataka , Aoyama Ikuo , Kawanami Chiharu , Shimizu Yoko , Maeda Sayako , Nozaki Akira , Yahata Kensei , Yoshioka Akira , Ono Shinji , Kirishima Toshihiko , Tomita Mayumi , Iehara Noriyuki , Tanaka Noriaki , Kinoshita Chiharu , Kataoka Shigeki , Nishikawa Yoshitaka , Hiragi Shusuke , Kitai Yuichiro , Nakagawa Shunsaku , Yonezawa Atsushi , Matsubara Kazuo , Ko Tadayuki , Yazumi Shujiro , Tsukamoto Tatsuo , Muso Eri , Hayakumo Takanobu , Takahashi Toshikazu , Toyoda Masanori , Nakai Kentaro , Nishi Shinichi , Tsumura Takehiko , Osaki Yukio , Nishioka Keisuke , Sugawara Akira , Yasui Hisateru , Yoshimoto Akihiro , Tanabe Katsuyuki , Inoue Tatsuyuki , Kitagawa Masashi , Baba Eishi , Nakano Toshiaki , Tsuruya Kazuhiko , Terasaka Soshi , Mitsuiki Koji , Suyama Koichi , Kuwabara Takashige , Mukoyama Masashi , Nangaku Masaomi , Hanafusa Norio , Honda Kenjiro , Aragane Naoko , Katsuya Hiroo , Harada Yohei 
Published: December 2024

ABSTRACT

Background
Cancer is a leading cause of death among patients on hemodialysis; however, the data on its diagnosis, treatment and prognosis are limited. Here we analyzed the surgical practice patterns and outcomes of patients on hemodialysis with cancer and compared them with those of general cancer patients from the National Cancer Center database.

Methods
This nationwide registry enrolled hemodialysis patients who were subsequently diagnosed with primary cancers of the kidney, colorectum, stomach, lung, liver, bladder, pancreas and breast in 20 hospitals in Japan between 2010 and 2012. The primary endpoint was the overall 3-year survival rate. We also examined the association of factors with mortality using Cox regression analysis.

Results
Of the 502 patients, 370 (74%) underwent surgery. More than half of the patients (57%) were asymptomatic at diagnosis and diagnosed with cancer through screening. Among the patients who underwent surgery, most (99%) had resectable cancers; while among those who did not undergo surgery, more than half (52%) had metastatic cancers. The 3-year overall survival in the surgery and non-surgery groups was 83% and 32%, respectively. Non-cancer-related deaths were dominant (80%) in the surgery group, whereas cancer-related deaths were dominant in the non-surgery group (70%). Pancreatic cancer and anemia were associated with a poor prognosis in the surgery group. Surgery and 3-year overall survival rates were comparable between the patients on hemodialysis and the general cancer patients.

Conclusion
Prognosis in hemodialysis cancer patients might be equivalent to that of general cancer patients.