P1523TREATMENT OF ADVANCED NON-SMALL CELL LUNG CANCER IN DIALYSIS PATIENTS; FINDINGS FROM OSAKA CANCER REGISTRY DATA

Abstract Background and Aims Recent advances in dialysis technic for end-stage renal disease have resulted in a longer survival. Consequently, they have an increased risk of suffering from various neoplastic diseases. The survival outcome and treatment rate in non-small cell lung cancer(NSCLC) patients on dialysis has not been well evaluated. In patients with unresectable stage disease, chemotherapy may best be started soon after the diagnosis of unresectable NSCLC has been made. The aim of this study was to investigate the practice pattern and survival rate in advanced NSCLC patients on dialysis. Method This retrospective study used population-based cancer registry data from Osaka Prefecture, Japan and administrative claims data produced under the Diagnosis Procedure Combination reimbursement system. We performed record linkage between these datasets to obtain patient-level information on dialysis, cancer diagnoses, treatment, and vital statuses. Patients who were diagnosed with advanced NSCLC between 2010 and 2015 and were at the age of 80 years or younger. We calculated the performance proportions of chemotherapy (including molecular-targeted drugs) in dialysis patients and non-dialysis chemotherapy. In addition, we computed one-year survival rate of patients in dialysis patients who underwent chemotherapy and who did not undergo. Results We identified 42 dialysis patients with a median age of 71 years and 18,425 non-dialysis patients with a median age of 70 years who were diagnosed with advanced NSCLC. Dialysis patients (n=11, 26.2 %) were less likely to receive chemotherapy when compared with non-dialysis patients (n=12247, 66.3%). Among dialysis patients, there was no significant difference in 1-year survival rate between the receipt (40.0%) and the non-receipt (29.6%) of chemotherapy (Log-rank test, p=0.41). Conclusion Dialysis patients might receive suboptimal treatment for advanced NSCLC. Further studies are needed to assess whether chemotherapy improves survival outcomes in dialysis patients with advanced NSCLC.