Abstract
The number of dialysis patients in Japan has been increasing year by year. The number of patients exceeded 330,000 in 2017, with their long-term survival achieved by the progress of dialysis technology and management. Because the chances of treating malignant tumors for dialysis patients who have various complications and risks for surgical treatment are expected to increase in the future, surgeons have to take surgery and perioperative management more seriously. However, there are few reports on dialysis patients in the head and neck cancer surgery. The aim of this study is to know the benefits and risks of invasive head and neck cancer surgery for patients undergoing dialysis. The subjects were 10 chronic dialysis patients who underwent free flap reconstructive surgery at our hospital from April 2007 to December 2018 (6 males, 4 females, average age 71.3 years), and the primary site was 7 oral cancers, one laryngeal cancer, one hypopharyngeal cancer and one submandibular adenocarcinoma. The average maintenance dialysis period was 3.7 years and postoperative complications were observed in 60% of the cases. The 3-year overall survival rate was 30% and the 3-year disease-specific survival rate was 54.9%. Compared with tongue reconstruction group in our institute, the 3-year overall survival rate was superior in the tongue reconstruction group (P＝0.01), but there was no significant difference in 3-year disease-specific survival rate (P＝0.38). The local control rate was 90%.
Although the risk of postoperative complication after free flap reconstructive surgery is high in dialysis patients, optimal treatment with head and neck oncological surgery is useful because it provides good control of cancer in terms of prognosis and local control.
