Does Chronic Kidney Disease Affect the Surgical Outcome and Prognosis of Patients with Gastric Cancer? A Meta-Analysis

Abstract

Purpose:

The purpose of this meta-analysis was to evaluate the impact of chronic kidney disease on short-term complications and long-term survival in patients with gastric cancer.

Methods:

The PubMed, Embase, and Cochrane Library databases were searched from inception to May 18, 2021. The search strategy focused on two keywords: chronic kidney disease and gastric cancer. Pooled odds ratios, mean differences, and hazard ratios were analyzed. RevMan 5.3 was used for data analysis in this meta-analysis.

Results:

A total of seven studies including 3,346 patients were included in this meta-analysis. The chronic kidney disease group had a higher proportion of males and older patients, lower albumin levels, higher comorbidity rates, and higher N staging. The chronic kidney disease group had higher rates of overall postoperative complications (OR = 2.05, 95% CI = 1.38 to 3.05, P = 0.0004), more severe postoperative complications (OR = 2.06, 95% CI = 1.59 to 2.66, P < 0.00001), and higher rates of cardiovascular-related complications, anastomotic leakage, pneumonia, wound infections, pancreatic-related diseases and short-term death. Furthermore, the chronic kidney disease group had poorer overall survival than the nonchronic kidney disease group (HR = 2.89, 95% CI = 2.20 to 3.80, P < 0.00001).

Conclusion:

Preexisting chronic kidney disease was associated with higher complications and poorer overall survival following gastrectomy in patients with gastric cancer.

Acknowledgments

We acknowledge all the authors whose publications are referred in our article. We are grateful to Wei Zhang who helped and edited this meta-analysis.

Disclosure Statement

The authors declare that they have no conflict of interests.

Funding

The study was supported by the joint program of Chongqing Municipal Health and Health Committee, Chongqing Science and Technology Bureau (No. 2021MSXM107).