만성 투석환자에서의 암 발생

Abstract

ABSTRACT

Cancer in ESRD patients

You Mi-Ra Advisor : Prof. Park Chi-Young M.D. Ph.D Department of Medicine, Graduate School of Chosun University

(Background) Previous studies have suggested that the frequency of cancer is higher in patients with dialysis and kidney transplantation than in the general population. There are few reports regarding cancer incidence of patients treated with dialysis in Korea. The aim of this study was to investigate the incidence, types of cancer, time to discovery of cancer and effect of early screening among patients on dialysis in Chosun University Hospital.

(Method) The study subjects were 25 cancer patients out of 796 end-stage renal disease (ESRD) patients maintained on hemodialysis or peritoneal dialysis at Chosun University Hospital from January 2002 to March 2010. We observed frequency of cancer, dialysis mode, cause of ESRD, time to discovery of cancer, cancer staging and cancer therapy among these patients.

(Result) Among the study population (796 ESRD patients), malignant disease was diagnosed in 25 patients(3.14%). Mean age at first dialysis was 54.3 years of age. Mean age at cancer diagnosis was 59.4 years of age. Seventeen (68%) of our subjects were male and eight (32%) were female. The mean time from the start of dialysis to the diagnosis of cancer was 49.3(0-168) months. The most common cancer site was the gastrointestinal tract (GIT) (32%) followed by the urinary tract (20%) and genital tract (16%). During first year, cancer incidence was higher compared to other periods. Except for stage II, a lower stage was associated with a longer interval to diagnosis of the cancer.

(Conclusion) In ESRD patients, the incidence of GIT cancer and urinary tract cancer is higher, thus, careful surveillance for malignancies is recommended.

Key word : End-Stage Renal Disease (ESRD), Cancer, dialysis