1632 - Hemodialysis in cervical cancer patients: clinical aspects and outcome in 95 patients from the Brazilian National Cancer Institute (INCA)

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Cervical Cancer
Presenter Diego Candido Reis
Authors D.G. Candido Reis1, L.M.C. Soares1, D. Herchenhorn1, I.S. Martins2, E. Rocha3
  • 1Medical Oncology, Brazilian National Cancer Institute, Rio de Janeiro/BR
  • 2Serviço De Infectologia, Universidade Federal Fluminense, 24033-900 - Niterói/BR
  • 3Departamento De Nefrologia, Hospital Universitário Clementino Fraga Filho- UFRJ, Rio de Janeiro/BV

Abstract

Cervical Cancer is a serious issue in development and underdeveloped countries. It is the second most prevalent (18000 new cases expected for 2012) and the fourth deadliest cancer among women in Brazil. Most patients (pts) (68,3%) are diagnosed with advanced disease- increasing their risk of renal failure due to local progression and cisplatin-based chemotherapy. Benefits of hemodialysis in these patients are unknown, and it should be better clarified due to its cost and morbidity.

Material and methods

Data were retrospectively assessed from all 95 consecutive patients diagnosed with cervical cancer submitted to renal substitute therapy in the years of 2007/2008, with a follow-up until March 2010. Statistical analysis was performed using software SPSS v11.0. Median Age of Diagnosis and at 1st Hemodialysis (1HD) were, respectively, 50.72y (25.39-95.13) and 52.06y (25.41-95.70). 70 pts (73,7%) had stage III or IV at the moment of diagnosis and 81 pts (85,3%) had disease progression at the moment of the 1HD. Main reason for HD was post-renal kidney failure in 84pts (88%). 34 pts (36%) received any kind of chemotherapy at the moment of 1HD and 5 pts (5%) developed nephrotoxicity due to chemotherapy. 87pts (91,6%) were dead at the moment of analysis, and 67pts (77%) died in the first 3 months after the 1HD. The Median Survival for the entire cohort was 41 days (CI95% 25-57 days). The main causes of death were cancer (83%) and sepsis (5%). In a Multiple Logistic Analysis using Cox Model, a significant difference was found in the Median Survival in the following categories: Age at First HD (<55 years: 62 days (CI95: 27-970); >55 years: 25 days (CI95: 9-41), HR = 0.259, p = 0.020); Tumor Status at the moment of HD (stable diase/partial response/no evidence of disease: 52 days (CI95: 30-74); Disease Progression/active disease: 39 days (CI95: 20-58), HR = 0.052, p = 0.003); Renal Drainage (not performed: 20 days (CI95: 7-33); performed: 67 days (CI95: 39-95), HR = 2.287, p = 0.003).

Conclusions

Overtreatment is common in oncology, from anti-cancer therapy to supportive care, and this can be hazardous to the patients. Most patients who were submitted to HD in this cohort had active advanced disease, and renal failure seemed to be a surrogate of poor prognosis/outcome. Patients who most benefited from HD was those younger than 55y and those with controlled disease.

Disclosure

All authors have declared no conflicts of interest.