由存活分析觀點探討臺灣惡性腫瘤患者接受透析治療之需要性

Abstract

本研究為一回溯性世代研究，採病例回顧方式，從 1997 年開始到 2008 年，資料為第二手資料，收集登錄在全民健康保險研究資料庫的長期透析患者，和罹患惡性腫瘤的病人。透析有 115,878 人，惡性腫瘤 741,471 人，其中惡性腫瘤後接受透析 5,609 人，收案時間為 12 年。 研究發現：惡性腫瘤患者接受長期透析治療，其死亡風險在子宮內膜、甲狀腺、皮膚、卵巢輸卵管及寬韌帶、非何杰金氏淋巴瘤、食道、鼻咽惡性腫瘤無差異。但在口腔、口咽、及下咽、子宮頸、子宮體、肝及肝內膽管、乳房、肺支氣管氣管、胃、結腸、直腸、乙狀結腸連接部及肛門惡性腫瘤，接受透析差於未接受透析者。泌尿道系統如腎盂及其他、腎、膀胱、攝護腺惡性腫瘤，也是接受透析差於未接受透析者。

This study is a retrospective cohort study, collected cases reviewed, from 1997 to 2008. It is the secondary hand data from the National Health Insurance Research Database. We collect the the long-term dialysis patients, and patients suffering from cancer. The patient receive dialysis is 115,878, 741,471 cancer, including 5,609 people receiving dialysis after cancer, to close the case for 12 years. Result: Cancer patients receiving long-term dialysis treatment, the risk of death in the endometrium, thyroid, skin, ovaries and broad ligament fallopian tube, non-Hodgkin's lymphoma, esophageal, nasopharyngeal cancer is no different. But in the oral cavity, oropharynx, and hypopharynx, cervix, uterus, liver and intrahepatic bile duct, breast, lung and bronchus trachea, stomach, colon, rectum, sigmoid junction and anus cancer, there are significant differences in dialysis worse than those who did not receive dialysis. Genitourinary system such as the renal pelvis, kidney, bladder, prostate cancer also have significant differences, but also on dialysis worse than those who did not receive dialysis.