Experience of nine south eastern European transplant centers with testicular cancer in kidney transplant recipients.

Abstract

Purpose: Testicular cancer (TC) is the most common type of cancer among young men aged 25 to 45. This study represents the first population study of TC in kidney transplant recipients (KTRs).

Methods: We conducted a multicentric, multinational, cross-sectional study across nine transplant centers in Croatia, Serbia, Montenegro, Slovenia, and Bosnia and Herzegovina. All KTRs over 18 years old who were regularly monitored at their transplant centers were included. Data were collected from electronic medical records at these centers.

Results: Out of the 4426 KTRs who participated in our study, six (0.14%) developed TC after KT. Two of these patients had a history of malignancy before KT, while four had a positive family history of malignancy. The median age at diagnosis of TC was 41 years. Follow-up time ranged from 1 to 14 years. Most of the patients underwent surgical treatment and half received adjuvant chemotherapy and/or radiotherapy. Four patients had seminoma and two had non-seminoma. In most cases, the immunosuppressive therapy was adjusted. Half of the patients maintained stable kidney allograft function after TC treatment. One patient died due to COVID-19 and two required chronic dialysis 8-9 years after their TC diagnosis and treatment.

Conclusions: In our study, TC occurred in the same age range as in the general population. A personal or family history of malignancy was identified as a significant risk factor. Outcomes for kidney allograft function and overall survival were excellent for patients whose disease was detected early and treated with orchiectomy. Switching from calcineurin to mTOR inhibitors also supported allograft survival.