De Novo Urological Malignancies After Renal Transplantation: An Asian 30-Year Experience

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-07-25 DOI:10.1111/ctr.15415

Han Jie Lee, Ee Jean Lim, Shauna Jia Qian Woo, Edwin J. Aslim, Lay Guat Ng, Valerie Huei Li Gan

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Abstract

Background

As the incidence of urological malignancies after renal transplantation (RT) is observed to be greater than in the general population, a better understanding of them is important. We present our experience with urological tumors in RT recipients at our transplant center, and analyze their incidence, management and outcomes.

Materials and Methods

A retrospective analysis of 2177 RT recipients on follow-up at our center between 1990 and 2022 was conducted for de novo genitourinary malignancy. Patients diagnosed with malignancy before transplantation were excluded. Clinicopathological data at diagnosis and follow-up were collected and analyzed. Kaplan-Meier estimates were used to evaluate overall survival (OS) and cancer-specific survival (CSS). Statistical analysis was performed using IBM SPSS v.24 (IBM Corp., Armonk, NY, USA).

Results

The overall incidence of Urological malignancies was 3.9%, with 89 cancers diagnosed in 85 patients. Renal cell carcinoma was most common (n = 61, 68.5%), followed by prostate cancer (n = 10, 11.2%), urothelial carcinoma (n = 10, 11.2%), squamous cell carcinoma of the penis/scrotum (n = 7, 7.9%), and testicular cancer (n = 1, 1.1%). Mean duration between transplantation and diagnosis of malignancy was 9.9 (0.4–20.7) years. At a median follow-up of 4.6 (018.2) years, 27 deaths were seen; 7(25.9%) were due to urological malignancy. CSS rates were 86% and 78% at five and ten years, respectively, after diagnosis.

Conclusion

We present one of the largest series of de novo urological malignancies observed over an extended 30-year follow-up of RT recipients, demonstrating an elevated risk in line with other studies. Regular surveillance for malignancies is advised, in order to ensure early diagnosis and management.

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肾移植后新发泌尿系统恶性肿瘤：亚洲 30 年的经验

背景：据观察，肾移植（RT）后泌尿系统恶性肿瘤的发病率高于普通人群，因此更好地了解这些肿瘤非常重要。我们介绍了移植中心 RT 受者泌尿系统肿瘤的经验，并分析了其发病率、管理和预后：我们对本中心 1990 年至 2022 年间随访的 2177 例 RT 受者进行了新发泌尿生殖系统恶性肿瘤的回顾性分析。排除了移植前诊断为恶性肿瘤的患者。收集并分析了诊断和随访时的临床病理数据。采用卡普兰-梅耶估计法评估总生存期（OS）和癌症特异性生存期（CSS）。统计分析采用 IBM SPSS v.24 (IBM Corp., Armonk, NY, USA)：泌尿系统恶性肿瘤的总发病率为 3.9%，85 名患者共确诊 89 种癌症。肾细胞癌最常见（61例，68.5%），其次是前列腺癌（10例，11.2%）、尿路上皮癌（10例，11.2%）、阴茎/阴囊鳞状细胞癌（7例，7.9%）和睾丸癌（1例，1.1%）。从移植到确诊恶性肿瘤的平均时间为 9.9 (0.4-20.7) 年。中位随访时间为4.6 (018.2)年，共有27人死亡，其中7人（25.9%）死于泌尿系统恶性肿瘤。确诊后五年和十年的CSS率分别为86%和78%：我们对接受 RT 治疗的患者进行了长达 30 年的随访，观察到了新发泌尿系统恶性肿瘤，这是规模最大的系列研究之一，与其他研究结果一致。建议定期监测恶性肿瘤，以确保早期诊断和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.