Semin Cho, Eunjeong Kang, Ji Eun Kim, U Kang, Hee Gyung Kang, Minsu Park, Kwangsoo Kim, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Hyung-Jin Yoon, Hajeong Lee
Cancer Res Treat. 2021;53(4):1015-1023. Published online January 18, 2021
Purpose
Acute kidney injury (AKI) in cancer patients is associated with increased morbidity and mortality. The incidence of AKI in lung cancer seems to be relatively higher compared with other solid organ malignancies, although its impact on patient outcomes remains unclear.
Materials and Methods
The patients newly diagnosed with lung cancer from 2004 to 2013 were enrolled in this retrospective cohort study. The patients were categorized according to the presence and severity of AKI. We compared all-cause mortality and long-term renal outcome according to AKI stage.
Results
A total of 3,202 patients were included in the final analysis. AKI occurred in 1,783 (55.7%) patients during the follow-up period, with the majority having mild AKI stage 1 (75.8%). During the follow-up of 2.6±2.2 years, total 1,251 patients (53.7%) were died and 5-year survival rate was 46.9%. We found that both AKI development and severity were independent risk factors for all-cause mortality in lung cancer patients, even after adjustment for lung cancer-specific variables including the stage or pathological type. In addition, patients suffered from more severe AKI tend to encounter de novo chronic kidney disease development, worsening kidney function, and end-stage kidney disease progression.
Conclusion
In this study, more than half of the lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with a higher mortality risk and adverse kidney outcomes.
Citations
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Kwang Hyub Han, Sang Hoon Ahn, Dong Ki Kim, Ki Joon Song, Jung Il Jeong, Kwan Sik Lee, Jae Bock Chung, Chae Yoon Chon, Young Myoung Moon, Il Suh, Jung Mo Nam
PURPOSE To evaluate the effectiveness of clinic-based screening program for early detection of hepatocellular carcinoma (HCC) and to assess the risk factors of HCC in Korea. MATERIALS AND METHODS The data of 14,259 patients who had ultrasonography (US) due to chronic liver diseases were collected into a data base program from 1990 to 1998. RESULTS A total of 4,339 patients were enrolled who had repeated US. 237 patients were diagnosed as HCC during follow-up (mean 33 months). The tumor size detected by screening within a 6-months interval was significantly smaller than that of a longer interval (2.7 cm vs 3.9 cm, P<0.01). The smaller the tumor was at detection, the longer the survival time was. Only 29.9% of HCC patients had an elevated serum alpha-fetoprotein (alphaFP) level above 400 ng/ml.
Multivariate analysis showed liver cirrhosis, chronic hepatitis B or C and old age over 40 years to be significantly associated with an increased risk of HCC. CONCLUSION The US screening within a 6-months interval is beneficial to high-risk patients over 40 years old through the early detection of HCC and prolonged survival. According to the risk factors, the necessity for screening test and proper interval should be reconsidered.