Incidence of malignancy and related mortality after kidney transplantation: a nationwide, population-based cohort study in Korea

Abstract

Post-transplant malignancy (PTM) is a leading cause of premature mortality among kidney transplantation recipients. However, population-based cohort studies that cover incidence, mortality, and risk factors for PTM are rarely reported, especially in East Asia. We designed a retrospective cohort study using a national population-based database. A total of 9915 kidney recipients between 2003 and 2016 were included. During this period, 598 cases (6.0%) of de novo PTM occurred. The most common PTM was thyroid cancer (14.2%), followed by colorectal (11.2%), kidney (10.7%), and stomach cancers (8.9%). The standardised incidence ratio for all-site cancer was 3.9. The risks of Kaposi sarcoma (192.9) and kidney cancer (21.1) were more than 10 times those of the general population. Cancer-related deaths were 89 (14.9%) with liver cancer being the highest (14.6%), followed by lung cancer (13.5%), non-Hodgkin lymphoma (NHL) (12.4%), stomach cancer (9.0%), and colorectal cancer (7.9%). The standardised mortality ratio (SMR) was slightly elevated (1.4). A notable increase in SMR was observed for lymphoma (9.3 for Hodgkin lymphoma and 5.5 for NHL). Older age and graft failure were significantly related to PTM. These findings reflecting geographical variation have implications for the development of strategies for fatal cancers to prevent premature deaths from PTM.

De Novo Cancer Incidence after Kidney Transplantation in South Korea from 2002 to 2017

“…Currently, a similar study about the incidence of malignancy and related mortality in 9,915 KT recipients using the database of the Health Insurance Review and Assessment Service (HIRA) from 2003 to 2016 has been published [22]. Compared to that study, we used NHID, a more comprehensive database which includes the HIRA database.…”

“…In Asian countries, renal cancer, gastric cancer, non-Hodgkin lymphoma, and transitional cell carcinoma occur more frequently in KT recipients [16][17][18][19]. Previous studies about Korean KT population are based on either single-center data or nationwide population reported cancer incidence and type of cancer in KT recipients [20][21][22]; however, an up-todate analysis has to be performed, and the risk factors associated with the development of post-transplantation cancer need to be identified based on the most current nationwide population data.…”

Alteraciones neoplásicas en el paciente trasplantado renal. Una revisión sistemática

“…El segundo trasplante se relacionó con un mayor riesgo para el desarrollo de malignidades postrasplante. que en la general, y, por tanto, una complicación potencial a tener en cuenta en estos pacientes [24][25][26][27][28][29][30][31][32][33][34][35][36][37] .…”

“…Con respecto al sexo de los pacientes, a excepción de un solo artículo en el que dicha población fue exclusivamente femenina 37 , el resto nos ha permitido observar y comprobar la diferencia entre ambos sexos [24][25][26][27][28][29][30][31][32][33][34][35][36] .…”

High Level of Aristolochic Acid Detected With a Unique Genomic Landscape Predicts Early UTUC Onset After Renal Transplantation in Taiwan

“…Immunosuppressive agents are crucial for suppression of allograft rejection but may predispose to the development of tumors ( 13 ). Sirolimus, also known as rapamycin, is a mammalian target of rapamycin (mTOR) inhibitor and has both immunosuppressive and anti-UC effects ( 14 ).…”