Surgical Treatment of Gastric Malignancy in Chronic Kidney Disease Patient with Long-Term Haemodialysis

Background. Gastric cancer is the world 5th top malignancy, with treatment success largely conditioned by comorbidity. Patients with end-stage renal failure developed with chronic kidney disease could not expect a specialty cancer treatment before the advent of long-term haemodialysis.

Aim. A case description of successful perioperative therapy and surgery in a long-term haemodialysis patient performed by a multi-specialty team of oncologists and transplantologists.

Materials and methods. We case-illustrate surgical treatment options in a gastric cancer patient with long-term haemodialysis.

Results and discussion. A specialty oncological treatment of end-stage renal failure patients requiring long-term haemodialysis is a complex multidisciplinary task feasible in hospitals equipped for different haemodialysis regimens. The treatment plan should be laid out by a multi-specialty team, as chronic kidney disease influences the choice of the drug class, dosage and administration mode. Moreover, such patients need laboratory (control of acid-base balance, haemoglobin, electrolytes, creatinine and urea) and clinical (body weight, liquid balance, etc.) monitoring.

Conclusion. Perioperative management studies in gastric cancer and chronic kidney disease-comorbid patients under long-term haemodialysis is a promising area of combining eff ort in oncology and transplantation science. Further research is needed in this topic for data enrichment and analysis in complex comorbidity patients.

1. Warsinggih R., Syarifuddin E., Marhamah, Lusikooy R.E., Labeda I., Sampetoding S., et al. Association of clinicopathological features and gastric cancer incidence in a single institution. Asian J. Surg. 2021. Epub 2021 Jun 3.

2. Abdullaev A.G., Allahverdiev A.K., Besova N.S., Byahov M.Y., Gorbunova V.A., Davidov M.I., Davidov M.I., et al. Stomach cancer. Clinical guidelines. Moscow, 2018. Available from: http://www.oncology.ru/association/clinical-guidelines/2018/rak_zheludka_pr2018.pdf (In Russ.).

3. Ludwig K., Möller D., Bernhardt J. Surgical management for early stage gastric cancer. Chirurg. 2018;89(5):347–57. DOI: 10.1007/ s00104-017-0541-x

4. Norero E., Vargas C., Achurra P., Ceroni M., Mejia R., Martinez C., et al. Survival and perioperative morbidity of totally laparoscopic versus open gastrectomy for early gastric cancer: analysis from a single Latin American centre. Arq Bras Cir Dig. 2019;32(1):e1413. DOI: 10.1590/0102-672020180001e1413

5. Myung J., Choi J.H., Yi J.H., Kim I. Cancer incidence according to the National Health Information Database in Korean patients with end-stage renal disease receiving hemodialysis. Korean J Intern Med. 2020;35(5):1210–9. DOI: 10.3904/kjim.2018.400

6. Otani Y., Okabayashi T., Shima Y., Shibuya Y., Ozaki K., Iwata J., et al. Safety and effi cacy of the surgical management of hemodialysis patients with gastric cancer. Acta Med Okayama. 2017;71(4):333–9. DOI: 10.18926/AMO/55310

7. Shestakov A.L., Nikoda V.V., Boyeva I.A., Shahbanov M.E., Marchenko T.V., Zaytsev A.Yu., et al. Questions of safety of surgical treatment of a patient with early stomach cancer on programmed haemodialisis. Clinical and Experimental Surgery. Petrovsky Journal. 2021;9(1):99– 106 (In Russ.). DOI: 10.33029/2308-1198-2021-9-1-99-106

8. Butler A.M., Olshan A.F., Kshirsagar A.V., Edwards J.K., Nielsen M.E., Wheeler S.B., et al. Cancer incidence among US Medicare ESRD patients receiving hemodialysis, 1996–2009. Am J Kidney Dis. 2015;65(5):763–72. DOI: 10.1053/j.ajkd.2014.12.013

9. Lin H.F., Li Y.H., Wang C.H., Chou C.L., Kuo D.J., Fang T.C. Increased risk of cancer in chronic dialysis patients: a population-based cohort study in Taiwan. Nephrol Dial Transplant. 2012;27(4):1585–90. DOI: 10.1093/ndt/gfr464

10. Chen D.P., Davis B.R., Simpson L.M., Cushman W.C., Cutler J.A., Dobre M., et al. Association between chronic kidney disease and cancer mortality: A report from the ALLHAT. Clin Nephrol. 2017;87(1):11– 20. DOI: 10.5414/CN108949

11. Kakekh M., Shogenova A.R., Bekizheva L.R., Attaeva M.Zh., Aramisova R.M., Kambachokova Z.A., et al. Comorbidity in patients on programmed hemodialysis. Diffi cult Patient. 2019;17(4):20–22 (In Russ.). DOI: 10.24411/2074-1995-2019-10025

12. Palamuthusingam D., Johnson D.W., Hawley C.M., Pascoe E., Sivalingam P., Fahim M. Perioperative outcomes and risk assessment in dialysis patients: current knowledge and future directions. Intern Med J. 2019;49(6):702–10. DOI: 10.1111/imj.14168

13. Matsumoto S., Takayama T., Wakatsuki K., Tanaka T., Migita K., Nakajima Y. Short-term and long-term outcomes after gastrectomy for gastric cancer in patients with chronic kidney disease. World J Surg. 2014;38(6):1453–60. DOI: 10.1007/s00268-013- 2436-4

14. Choi Y.K., Ahn J.Y., Na H.K., Jung K.W., Kim D.H., Lee J.H., et al. Outcomes of endoscopic submucosal dissection for gastric epithelial neoplasm in chronic kidney disease patients: propensity scorematched case-control analysis. Gastric Cancer. 2019;22(1):164–71. DOI: 10.1007/s10120-018-0848-4

15. Dindo D., Demartines N., Clavien P.A. Classifi cation of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13. DOI: 10.1097/01.sla.0000133083.54934.ae