Development of Urologic de Novo Malignancies After Renal Transplantation

Hevia, Vital; Gómez, Victoria; Nicolas, V.; Álvarez, Sara; Cañizo, C. Gómez del; Galeano, C.; Gomis, Antonio Giner; García-Sagredo, José Miguel; Marcén, R.; Burgos, Francisco

doi:10.1016/j.transproceed.2013.12.004

Cited by 41 publications

(31 citation statements)

References 20 publications

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“…From 1988 to 2016, a total of 56 studies were found reporting on SRMs in transplanted allograft kidneys . Our literature search yielded one multicenter retrospective case series, 19 single‐institution case series, and 36 case reports.…”

Section: Resultsmentioning

confidence: 99%

Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management

Griffith

Amin

Waingankar

et al. 2017

American Journal of Transplantation

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The objective of this review is to explore the available literature on solid renal masses (SRMs) in transplant allograft kidneys to better understand the epidemiology and management of these tumors. A literature review using PubMed was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Fifty-six relevant studies were identified from 1988 to 2015. A total of 174 SRMs in 163 patients were identified, with a mean tumor size of 2.75 cm (range 0.5-9.0 cm). Tumor histology was available for 164 (94.3%) tumors: clear cell renal cell carcinoma (RCC; 45.7%), papillary RCC (42.1%), chromophobe RCC (3%), and others (9.1%). Tumors were managed by partial nephrectomy (67.5%), radical nephrectomy (19.4%), percutaneous radiofrequency ablation (10.4%), and percutaneous cryoablation (2.4%). Of the 131 patients (80.3%) who underwent nephron-sparing interventions, 10 (7.6%) returned to dialysis and eight (6.1%) developed tumor recurrence over a mean follow-up of 2.85 years. Of the 110 patients (67.5%) who underwent partial nephrectomy, 3.6% developed a local recurrence during a mean follow-up of 3.12 years. The current management of SRMs in allograft kidneys mirrors management in the nontransplant population, with notable findings including an increased rate of papillary RCC and similar recurrence rates after partial nephrectomy in the transplant population despite complex surgical anatomy.

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Section: Resultsmentioning

confidence: 99%

Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management

Griffith

Amin

Waingankar

et al. 2017

American Journal of Transplantation

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“…In contrast to our findings, other studies have shown a longer median time of 3.9 to 7.4 years for development of RCC and 4.4 to 4.8 years for TCC after renal transplant. 14,15 However, our results demonstrate that some cancers were detected as early as 1 month and as late as 12.2 years after transplant. The cause for the shorter interval between transplant and diagnosis of renal cancer, particularly TCC, versus that shown in other reports is unclear.…”

Section: Discussionmentioning

confidence: 50%

Untitled

Ranasinghe

Suh²,

Hughes³

2016

Exp Clin Transplant

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Objectives: Our objective was to determine the incidence and outcomes of renal cell carcinoma and transitional cell carcinoma in recipients of renal allografts. Materials and Methods:We analyzed data from 2000 to 2012 in the Australia and New Zealand Dialysis and Transplant Registry, a binational population-based database, to identify the incidence and survival outcomes of renal transplant recipients with renal cell and transitional cell carcinoma. Results: Of the 8850 renal transplants, there were 60 new diagnoses of renal cancers posttransplant, with an overall cumulative incidence of 56 per 100 000 per year. Nine tumors were detected in the allograft, and 51 tumors (85%) were detected in the native kidney of the recipient. The median time of diagnosis from transplant was 6.6 years (range, 0.1-8.9 y). There were no cancerspecific deaths from allograft tumors; however, 17 cancer-specific deaths (14 from renal cell carcinoma and 3 from transitional cell carcinoma) occurred in patients with cancer in the native kidney. The 5-year and 10-year cancer-specific survival rates for renal cell carcinoma were 71.2% (95% confidence interval (CI): 57.0-84.0) and 58.5% (95% CI: 40.5-77.9), with 5-year and 10-year rates for transitional cell carcinoma of 50% (95% CI: 15.5-94.2) and 0%. Conclusions: Renal cell carcinoma occurring in the native kidney comprised most of the tumors detected after renal transplant; however, transitional cell carcinoma occurred sooner after transplant and resulted in a lower cancer-specific survival rate. While it is important to screen those at risk of TCC prior and after renal transplant, the low incidence of TCC maybe too small to justify a benefit with routine screening, compared to RCCs.

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“…Renal cell carcinoma was reported to be the most frequent posttransplant urologic tract cancer. 33,34 In this study, of the 9 urinary tract cancers, 3 of them were kidney-graft RCC and 3 were native kidney cancer. Renal allograft carcinoma was reported in a few case reports.…”

Section: Eda Yılmaz Akçay Et Al/experimental and Clinical Transplantamentioning

confidence: 83%

Untitled

Akçay

Tepeoğlu²,

Özdemir³

et al. 2016

Exp Clin Transplant

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Objectives: The aim of this study was to evaluate the incidence of posttransplant malignancy in kidney transplant patients and investigate the clinical and histopathologic features of these patients. Materials and Methods: We retrospectively reviewed information on donor and recipient characteristics, patient and graft survival, and cancer incidence after transplant for 867 kidney transplant patients. Patients with neoplasms prior to transplant were excluded. A follow-up study estimated cancer incidence after transplant. Results: Neoplasms were diagnosed in 59 patients (6.8%), 41 men and 18 women; 22 (37.3%) had skin tumors, 19 (32.2%) had solid tumors, 10 (16.9%) had posttransplant lymphoproliferative disorders, and 8 (13.6%) had Kaposi sarcoma. The mean age at the time of malignant tumor diagnosis was 42.7 ± 13.6 years, and statistically significant differences were found between tumor groups (P < .01). The average latency period between transplant and diagnosis of malignant tumors was 99.8 ± 56.9 months for solid tumors, 78.4 ± 52 months for skin tumors, 64.5 ± 48.8 months for posttransplant lymphoproliferative disorders, and 13.5 ± 8.8 months for Kaposi sarcoma, with significant difference found between tumor groups (P < .01). Ten patients (16.9%) had more than 1 malignant tumor. Eighteen patients died, with a mean time to death of 31.5 ± 22.8 months after tumor diagnosis. A significant positive association was found between survival and the number of tumors (P = .001); 5-year survival after tumor diagnosis was 81% and 40% for patients with 1 malignant tumor and patients with more than 1 malignant tumor, respectively. Conclusions:Malignancy is a common cause of death after renal transplant. Early detection and treatment of posttransplant malignancies is an important challenge. Screening these patients for malignancies posttransplant is crucial, and efforts should be directed to define effective immunosuppressive protocols that are associated with a lower incidence of malignancy.

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Development of Urologic de Novo Malignancies After Renal Transplantation

Cited by 41 publications

References 20 publications

Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management

Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management

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