Clémence Béchade1,2, Olivier Dejardin1,2, Simona Bara3,4, Véronique Bouvier1,2,5, Anne-Valérie Guizard2,6, Rémy De Mil1,2, Xavier Troussard3,7, Guy Launoy1,2, Thierry Lobbedez1,2. 1. University Hospital of Caen, Caen cedex, France. 2. Cancers & Preventions, U1086 INSERM-UCBN, Centre François Baclesse, Caen, France. 3. Francim: Réseau Français des Registres des Cancers, Toulouse, France. 4. Manche Cancer Registry, Cotentin Hospital, Cherbourg-Octeville, France. 5. Calvados Digestive Cancer Registry, Cancers & Preventions, U 1086 Inserm, Centre François Baclesse, Caen, France. 6. Calvados General Cancer Registry, Cancers & Preventions, U 1086 Inserm, Centre François Baclesse, Caen, France. 7. Lower Normandy Haematological Malignancies Cancer Registry, University Hospital of Caen, Caen cedex, France.
Abstract
AIM: Cancer and chronic kidney disease are known to be associated. The way in which a history of cancer can influence outcome in dialysis is not well described. This work aimed to evaluate survival of cancer patients starting chronic dialysis after their diagnosis of cancer. METHODS: We merged data from cancer registries and a dialysis registry, and explored patients' charts. RESULTS: Between January 2001 and December 2008, 74 patients with incident cancer in the two-counties-study-area (Calvados and Manche) started chronic dialysis after their diagnosis of cancer. Survival of these incident dialysis patients with a previous diagnosis of cancer was respectively 80.9% (confidence interval 69.9; 88.2) and 68.3% (confidence interval 56.3%; 77.7%) at 1 and 2 years. Only 29 of the 74 patients (39.2%) were still alive at the end of the observation period; median participation time was 2.8 years (1st and 3rd quartiles: 1.3-4.4). Survival of patients with cancer was not different to that of non-cancer dialysis patients matched for age and sex, except in patients with haematological malignancies who had a poorer outcome. In a multivariate stratified Cox model, the history of cancer before dialysis start was not associated with death, after adjustment on diabetes. CONCLUSION: In our study, survival in dialysis was not different among patients with a history of cancer compared to matched patients without malignancy. We can hypothesize that only some selected patients with cancer have access to dialysis. Studies in ESRD patients with cancer should be performed to evaluate access to dialysis in that population.
AIM: Cancer and chronic kidney disease are known to be associated. The way in which a history of cancer can influence outcome in dialysis is not well described. This work aimed to evaluate survival of cancerpatients starting chronic dialysis after their diagnosis of cancer. METHODS: We merged data from cancer registries and a dialysis registry, and explored patients' charts. RESULTS: Between January 2001 and December 2008, 74 patients with incident cancer in the two-counties-study-area (Calvados and Manche) started chronic dialysis after their diagnosis of cancer. Survival of these incident dialysis patients with a previous diagnosis of cancer was respectively 80.9% (confidence interval 69.9; 88.2) and 68.3% (confidence interval 56.3%; 77.7%) at 1 and 2 years. Only 29 of the 74 patients (39.2%) were still alive at the end of the observation period; median participation time was 2.8 years (1st and 3rd quartiles: 1.3-4.4). Survival of patients with cancer was not different to that of non-cancer dialysis patients matched for age and sex, except in patients with haematological malignancies who had a poorer outcome. In a multivariate stratified Cox model, the history of cancer before dialysis start was not associated with death, after adjustment on diabetes. CONCLUSION: In our study, survival in dialysis was not different among patients with a history of cancer compared to matched patients without malignancy. We can hypothesize that only some selected patients with cancer have access to dialysis. Studies in ESRDpatients with cancer should be performed to evaluate access to dialysis in that population.