In recent years, rhythmic fluctuations in life, organized by biological clocks, have been found to maintain health and prevent aging and certain diseases. Circadian signals are transmitted from the central clock in the suprachiasmatic nuclei located in the hypothalamus to the local clocks in the brain and most peripheral tissues, which coordinate the function of nerves, hormone secretion, and sleep-wake rhythms. Clock genes regulate the biological clock, and if their expression level decreases, the movement of the clock deteriorates, which harms health. Humans have an internal cycle of more than 24 h, and the appropriate timing is maintained according to external daily stimuli, such as morning light. Local clocks in the peripheral tissues have a strong direct response to external stimuli of stress, exercise, and/or food, that are independent of the central clock. Therefore, light exposure, diet, and exercise at the appropriate times of the day lead to a healthy lifestyle. Melatonin, a sleep hormone, begins to be secreted at night due to morning light, increases at night, and decreases at dawn, which is disrupted by light exposure at night; therefore, it is important to limit light exposure at night to maintain sleep.

Background: The incidence of postoperative complications is high in lung cancer patients with renal dysfunction, and their long-term outcomes are poor.

Methods: From January 2015 to December 2017, 268 patients who underwent surgical resection for clinical stage I-IIIA non-small cell lung cancer (NSCLC) were included in this study. The 244 patients with serum creatinine (Cre) levels of <1.5 mg/dL were assigned to the control (CT) group, 11 patients with serum Cre levels of ≥1.5 mg/dL who were not on hemodialysis were assigned to the renal dysfunction (RD) group, and 13 patients on dialysis were assigned to the hemodialysis (HD) group.

Results: The mean ages in the CT, RD, and HD groups were 68.6±9.9 years, 70.5±11.4 years, and 68.8±9.9 years, respectively, with no statistically significant difference among them. There were no significant differences in perioperative outcomes. The 5-year relapse-free survival rates in the CT, RD, and HD groups were 74.19%, 90.00%, and 75.52%, respectively, while the corresponding 5-year overall survival rates were 88.29%, 71.43%, and 76.15%, respectively, with no statistically significant differences among them.

Conclusion: This study indicates that surgical treatment should be considered for NSCLC patients with renal dysfunction.