| アブストラクト | BACKGROUND AND AIM: Because of the rarity of invasive treatment for hepatocellular carcinoma (HCC) in patients on hemodialysis (HD) for end-stage renal disease (ESRD), the risks associated with radiofrequency ablation (RFA) in such patients remain uncertain. We used a nationwide database to investigate in-hospital mortality and hemorrhagic complications following RFA in patients on HD for ESRD. METHODS: Using the Japanese Diagnosis Procedure Combination database, we enrolled patients on HD for ESRD who underwent RFA for HCC. For each patient, we randomly selected up to four non-dialyzed patients using a matched-pair sampling method based on patient age, sex, treatment hospital, and treatment year. In-hospital mortality and hemorrhagic complications were compared between dialyzed and non-dialyzed patients following RFA. RESULTS: We compared matched-pair samples of 437 dialyzed and 1345 non-dialyzed patients. In patients on HD for ESRD, mortality was significantly lower in those aged </=70 years than in older patients (P = 0.02). In-hospital mortality was significantly higher in dialyzed ESRD patients than in non-dialyzed patients (1.1% vs 0.15%, respectively; odds ratio = 7.77, P < 0.001). Hemorrhagic complications differed significantly between dialyzed ESRD patients and non-dialyzed patients (3.4% vs 0.87%, respectively; odds ratio = 4.75, P < 0.001). CONCLUSIONS: In-hospital mortality following RFA was higher in dialyzed ESRD patients than in non-dialyzed patients. The indications for RFA in dialysis-dependent patients should be considered carefully. Patient age may be a useful indicator when considering RFA for HCC in patients on HD for ESRD. |
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| ジャーナル名 | Journal of gastroenterology and hepatology |
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| 投稿日 | 2017/03/08 |
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| 投稿者 | Sato, Masaya; Tateishi, Ryosuke; Yasunaga, Hideo; Matsui, Hiroki; Horiguchi, Hiromasa; Fushimi, Kiyohide; Koike, Kazuhiko |
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| 組織名 | Department of Gastroenterology, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28266772/ |
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