Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea.
BMC Nephrol. 2020 Jul 23;21(1):297. doi: 10.1186/s12882-020-01969-5.
There are limited data focusing specifically on the types of arteriovenous (AV) access used and outcomes of AV access among cancer patients as a consequence of cancer. We aimed to describe outcomes of AV access among cancer patients requiring chronic haemodialysis, and also to compare outcomes between patients with and without cancer.
In this single-centre, retrospective, observational cohort study, 84 patients diagnosed with cancer before AV access placement were included; we analysed outcomes of AV access among these patients and compared these outcomes with our previous results. The study endpoints were AV access patency and early failure, defined as AV access abandonment within 12 months after AV access placement.
Various cancer types, stages, and treatments were identified in our analysis. Autologous arteriovenous fistulas (AVFs) were used for 92.9% of this study population. Using our previous results for comparison, we found no significant difference in death-censored primary (P = 0.546) and secondary (P = 0.266) patency of AV access between patients with and without cancer; however, the rate of early AVF failure was statistically significantly higher among cancer patients (25.6% vs 13.9%; P = 0.008), and the most common cause of AVF failure was patient death. The rate of early failure was significantly higher among patients with advanced-stage cancer (59.1%) than among those with early-stage cancer (12.9%) (P < 0.001).
Although AV access patency rates were similar among patients with and without cancer in the death-censored analysis, cancer patients were more prone to early AVF failure, mainly due to cancer-associated deaths, and this consideration needs to be carefully balanced against individual patients' life expectancies, according to cancer type and stage.
目前针对癌症患者因癌症而导致的动静脉（AV）通路类型和 AV 通路结局的相关数据有限。我们旨在描述需要进行慢性血液透析的癌症患者的 AV 通路结局，并比较有癌症和无癌症患者之间的结局。
在这项单中心、回顾性、观察性队列研究中，纳入了 84 名在 AV 通路置入前被诊断患有癌症的患者；我们分析了这些患者的 AV 通路结局，并将这些结局与我们之前的结果进行了比较。研究终点为 AV 通路通畅性和早期失败，定义为 AV 通路置入后 12 个月内放弃 AV 通路。
在我们的分析中确定了各种癌症类型、分期和治疗方法。自体动静脉瘘（AVF）用于该研究人群的 92.9%。为了进行比较，我们发现有癌症和无癌症患者的死亡相关的主要（P=0.546）和次要（P=0.266）AV 通路通畅率无显著差异；然而，癌症患者的早期 AVF 失败率统计学上显著更高（25.6%比 13.9%；P=0.008），AVF 失败的最常见原因是患者死亡。晚期癌症患者（59.1%）的早期失败率明显高于早期癌症患者（12.9%）（P<0.001）。
尽管在死亡相关分析中，有癌症和无癌症患者的 AV 通路通畅率相似，但癌症患者更容易发生早期 AVF 失败，主要是由于癌症相关的死亡，并且需要根据癌症类型和分期仔细权衡这一考虑因素与患者的预期寿命。
