Thyroid cancer and renal transplantation: a meta-analysis

Abstract

Kidney transplantation and the associated immune suppression are associated with a significantly increased risk of developing cancer during long-term follow-up. Thyroid cancer has been recognised as a potential post-transplant risk but has not yet been subject of a focused review. We therefore performed a meta-analysis on data of 50 861 patients with a total follow-up of 198 595 patient-years and identified a 6.9-fold higher standardised incidence ratio (95% confidence interval 5.6-8.7, P!0.001) of thyroid cancer post renal transplantation as compared with a non-transplant group. All such cancers were of papillary type as far as histopathology was known. The mean time to discovery was 6.0 years post transplantation. This puts thyroid cancer into the group of high cancer risk following solid organ transplantation which already includes cervical cancer, non-melanoma skin cancer, oral and lip cancer and haematological malignancies. It is unclear what causes the increased cancer incidence. Inclusion of thyroid ultrasound in long-term post-transplant evaluation may help to ensure timely recognition of this condition.

Post-transplantation Malignancy After Kidney Transplantation in Turkey

“…In our two patients with lung cancer, cancer occurrence times were at 2 and 10 years post-transplantation. Thyroid cancer risk was found to be 6.9% cancer occurrence time was a median of 6 years and cancer type was mainly papillary carcinoma by Karamchandani et al [18]. In our two patients with thyroid cancer, malignancy occurrence times were at 2 and 6 years post-transplantation and both have papillary carcinoma.…”

Incidence of Primary and Second Cancers in Renal Transplant Recipients: A Multicenter Cohort Study

“…For less frequent cancers (e.g. thyroid, small intestine, salivary glands) conflicting data are reported (4)(5)(6). Despite the increased incidence of cancer, conflicting reports exist on cancer prognosis in transplant recipients compared to nonimmunosuppressed patients, and whether in these patients survival is long enough to allow the development of second primary cancers.…”

Thyroid nodule and thyroid cancer management pre- and post-cardiac transplantation

“…A recent meta-analysis suggests a high risk of thyroid cancer development, specifically PTC, after transplant. 36 This population may also have more aggressive thyroid cancer with lymph node metastasis, especially to the lateral neck compartment and mediastinum. 37 In renal recipients, the median time to diagnosis of thyroid cancer occurs significantly earlier than in other cancers (68 vs 102 months), raising the possibility of differing oncogenic pathways.…”