The incidence of cancer recurrence and new cancer following commencement of dialysis

Wai H. Lim; Esther Ooi; Aashi Pankaj; Armando Teixeira-Pinto; Yingxin Lin; David W. Johnson; Carmel M. Hawley; Andrea K. Viecelli; Helen Pilmore; Matthew A. Roberts; Christopher E. Davies; Anoushka Krishnan; Germaine Wong

doi:10.1093/ckj/sfac124

The incidence of cancer recurrence and new cancer following commencement of dialysis

Wai H. Lim, Esther Ooi, Aashi Pankaj, Armando Teixeira-Pinto, Yingxin Lin, David W. Johnson, Carmel M. Hawley, Andrea K. Viecelli, Helen Pilmore, Matthew A. Roberts, Christopher E. Davies, Anoushka Krishnan, Germaine Wong

ANZDATA Registry

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Background: Patients with kidney failure have a higher cancer risk compared with the age-matched general population. However, the outcomes of incident dialysis patients with a prior cancer history are unknown. Methods: Using Australia and New Zealand Dialysis and Transplant Registry data (2000-2019), the outcomes and survival probabilities of incident dialysis patients with prior cancers and having experienced a cancer recurrence or having developed a new cancer after dialysis commencement were described. Results: Of 4912 patients with prior cancers before dialysis commencement, 323 (7%) and 343 (7%) patients experienced cancer recurrence or developed new cancers after dialysis initiation, respectively. The median time from dialysis commencement to cancer recurrence was 1.2 years [interquartile range (IQR) 0.5-2.8] and was 2.0 years (IQR 0.7-4.0) for new cancer occurrence. Of those with cancer recurrence, 80% presented with metastatic disease and one in two patients died from cancer, with a median time from cancer recurrence to death of 0.5 years (IQR 0.2-1.7). Of those who developed new cancer, urinary tract and respiratory cancers were the most frequent cancer types, with a median time from new cancer diagnosis to death of 1.3 years (IQR 0.4-3.1). The 3-year survival probabilities on dialysis following cancer recurrence and new cancer were 19% [95% confidence interval (CI) 15-24] and 41% (35-47), respectively. Conclusion: Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with Ë-50% surviving beyond 3 years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients.

Original language	English
Pages (from-to)	1770-1781
Number of pages	12
Journal	Clinical Kidney Journal
Volume	15
Issue number	9
DOIs	https://doi.org/10.1093/ckj/sfac124 https://doi.org/10.1093/ckj/sfac124
Publication status	Published or Issued - 1 Sept 2022

Keywords

cancer mortality
cancer recurrence
dialysis
mortality
new cancer
prior cancer

ASJC Scopus subject areas

Nephrology
Transplantation

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Lim, W. H., Ooi, E., Pankaj, A., Teixeira-Pinto, A., Lin, Y., Johnson, D. W., Hawley, C. M., Viecelli, A. K., Pilmore, H., Roberts, M. A., Davies, C. E., Krishnan, A., & Wong, G. (2022). The incidence of cancer recurrence and new cancer following commencement of dialysis. Clinical Kidney Journal, 15(9), 1770-1781. https://doi.org/10.1093/ckj/sfac124, https://doi.org/10.1093/ckj/sfac124

@article{8f7e376b8d4743b98d8dd7c1a59fe803,

title = "The incidence of cancer recurrence and new cancer following commencement of dialysis",

abstract = "Background: Patients with kidney failure have a higher cancer risk compared with the age-matched general population. However, the outcomes of incident dialysis patients with a prior cancer history are unknown. Methods: Using Australia and New Zealand Dialysis and Transplant Registry data (2000-2019), the outcomes and survival probabilities of incident dialysis patients with prior cancers and having experienced a cancer recurrence or having developed a new cancer after dialysis commencement were described. Results: Of 4912 patients with prior cancers before dialysis commencement, 323 (7%) and 343 (7%) patients experienced cancer recurrence or developed new cancers after dialysis initiation, respectively. The median time from dialysis commencement to cancer recurrence was 1.2 years [interquartile range (IQR) 0.5-2.8] and was 2.0 years (IQR 0.7-4.0) for new cancer occurrence. Of those with cancer recurrence, 80% presented with metastatic disease and one in two patients died from cancer, with a median time from cancer recurrence to death of 0.5 years (IQR 0.2-1.7). Of those who developed new cancer, urinary tract and respiratory cancers were the most frequent cancer types, with a median time from new cancer diagnosis to death of 1.3 years (IQR 0.4-3.1). The 3-year survival probabilities on dialysis following cancer recurrence and new cancer were 19% [95% confidence interval (CI) 15-24] and 41% (35-47), respectively. Conclusion: Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with {\"E}-50% surviving beyond 3 years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients. ",

keywords = "cancer mortality, cancer recurrence, dialysis, mortality, new cancer, prior cancer",

author = "Lim, {Wai H.} and Esther Ooi and Aashi Pankaj and Armando Teixeira-Pinto and Yingxin Lin and Johnson, {David W.} and Hawley, {Carmel M.} and Viecelli, {Andrea K.} and Helen Pilmore and Roberts, {Matthew A.} and Davies, {Christopher E.} and Anoushka Krishnan and Germaine Wong",

note = "Funding Information: Heart Foundation Future Leader Fellowship (Award 102538) Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Oxford University Press on behalf of the ERA.",

year = "2022",

month = sep,

day = "1",

doi = "10.1093/ckj/sfac124",

language = "English",

volume = "15",

pages = "1770--1781",

journal = "Clinical Kidney Journal",

issn = "2048-8505",

publisher = "Oxford University Press",

number = "9",

}

Lim, WH, Ooi, E, Pankaj, A, Teixeira-Pinto, A, Lin, Y, Johnson, DW, Hawley, CM, Viecelli, AK, Pilmore, H, Roberts, MA, Davies, CE, Krishnan, A & Wong, G 2022, 'The incidence of cancer recurrence and new cancer following commencement of dialysis', Clinical Kidney Journal, vol. 15, no. 9, pp. 1770-1781. https://doi.org/10.1093/ckj/sfac124, https://doi.org/10.1093/ckj/sfac124

TY - JOUR

T1 - The incidence of cancer recurrence and new cancer following commencement of dialysis

AU - Lim, Wai H.

AU - Ooi, Esther

AU - Pankaj, Aashi

AU - Teixeira-Pinto, Armando

AU - Lin, Yingxin

AU - Johnson, David W.

AU - Hawley, Carmel M.

AU - Viecelli, Andrea K.

AU - Pilmore, Helen

AU - Roberts, Matthew A.

AU - Davies, Christopher E.

AU - Krishnan, Anoushka

AU - Wong, Germaine

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background: Patients with kidney failure have a higher cancer risk compared with the age-matched general population. However, the outcomes of incident dialysis patients with a prior cancer history are unknown. Methods: Using Australia and New Zealand Dialysis and Transplant Registry data (2000-2019), the outcomes and survival probabilities of incident dialysis patients with prior cancers and having experienced a cancer recurrence or having developed a new cancer after dialysis commencement were described. Results: Of 4912 patients with prior cancers before dialysis commencement, 323 (7%) and 343 (7%) patients experienced cancer recurrence or developed new cancers after dialysis initiation, respectively. The median time from dialysis commencement to cancer recurrence was 1.2 years [interquartile range (IQR) 0.5-2.8] and was 2.0 years (IQR 0.7-4.0) for new cancer occurrence. Of those with cancer recurrence, 80% presented with metastatic disease and one in two patients died from cancer, with a median time from cancer recurrence to death of 0.5 years (IQR 0.2-1.7). Of those who developed new cancer, urinary tract and respiratory cancers were the most frequent cancer types, with a median time from new cancer diagnosis to death of 1.3 years (IQR 0.4-3.1). The 3-year survival probabilities on dialysis following cancer recurrence and new cancer were 19% [95% confidence interval (CI) 15-24] and 41% (35-47), respectively. Conclusion: Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with Ë-50% surviving beyond 3 years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients.

AB - Background: Patients with kidney failure have a higher cancer risk compared with the age-matched general population. However, the outcomes of incident dialysis patients with a prior cancer history are unknown. Methods: Using Australia and New Zealand Dialysis and Transplant Registry data (2000-2019), the outcomes and survival probabilities of incident dialysis patients with prior cancers and having experienced a cancer recurrence or having developed a new cancer after dialysis commencement were described. Results: Of 4912 patients with prior cancers before dialysis commencement, 323 (7%) and 343 (7%) patients experienced cancer recurrence or developed new cancers after dialysis initiation, respectively. The median time from dialysis commencement to cancer recurrence was 1.2 years [interquartile range (IQR) 0.5-2.8] and was 2.0 years (IQR 0.7-4.0) for new cancer occurrence. Of those with cancer recurrence, 80% presented with metastatic disease and one in two patients died from cancer, with a median time from cancer recurrence to death of 0.5 years (IQR 0.2-1.7). Of those who developed new cancer, urinary tract and respiratory cancers were the most frequent cancer types, with a median time from new cancer diagnosis to death of 1.3 years (IQR 0.4-3.1). The 3-year survival probabilities on dialysis following cancer recurrence and new cancer were 19% [95% confidence interval (CI) 15-24] and 41% (35-47), respectively. Conclusion: Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with Ë-50% surviving beyond 3 years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients.

KW - cancer mortality

KW - cancer recurrence

KW - dialysis

KW - mortality

KW - new cancer

KW - prior cancer

UR - http://www.scopus.com/inward/record.url?scp=85141270670&partnerID=8YFLogxK

U2 - 10.1093/ckj/sfac124

DO - 10.1093/ckj/sfac124

M3 - Article

C2 - 36003660

SN - 2048-8505

VL - 15

SP - 1770

EP - 1781

JO - Clinical Kidney Journal

JF - Clinical Kidney Journal

IS - 9

ER -

The incidence of cancer recurrence and new cancer following commencement of dialysis

Abstract

Keywords

ASJC Scopus subject areas

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