Skip to main content

Advertisement

SpringerLink
Log in

Treatment of advanced rectal cancer in a patient after combined pancreas–kidney transplantation

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

Organ transplantation is a standard procedure today. Due to immunosuppressive drugs and increasing survival after organ transplantation, patients with transplanted organs carry an increased risk of developing malignant tumours. Accordingly, more patients with malignant tumours after transplantation will be faced by general or oncology surgeons. We report the case of a 48-year-old patient with advanced rectal cancer 6.5 years after pancreas–kidney-transplantation for type I diabetes.

Method

The patient was treated with neo-adjuvant radio-chemotherapy, followed by low anterior rectal resection with total mesorectal excision. Consecutively, a solitary hepatic metastasis, a solitary pulmonary metastasis and a chest wall metastasis were resected over the course of 13 months.

Result

The patient eventually died of metastasized cancer 32 months after therapy had been initiated, his organ grafts functioning well until his death.

Conclusion

Our case report provides evidence that transplantation patients should receive standard oncology treatment, including neo-adjuvant treatment, so long as their general condition and organ graft functions allow us to do so, although a higher degree of morbidity might be encountered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sutherland DE, Gruessner RWG, Dunn DL, Matas A, Humar A, Kandaswamy R, Mauer SM, Kennedy WR, Goetz FC, Robertson RP, Gruessner AC, Najarian JS (2001) Lessons learned from more than 1000 pancreas transplants at a single institution. Ann Surg 233:463–501

    Article  CAS  PubMed  Google Scholar 

  2. Pirson Y, Vandeleene B, Squifflet JP (2000) Kidney and kidney–pancreas transplantation in diabetic recipients. Diabetes Metab 26 [Suppl 4]:86–89

    Google Scholar 

  3. Hopt UT, Benz S, Pfeffer F, Schareck W, Irkin I, Busing M (1994) Simultaneous pancreas/kidney transplantation—the optimal therapy for the type I diabetics with end-stage renal disease in Europe, too? Transpl Int 7 [Suppl 1]:S414–S416

  4. Sheiner PA, Magliocca JF, Bodian CA, Kim-Schluger L, Altaca G, Guarrera JV, Emre S, Fishbein TM, Guy SR, Schwartz ME, Miller CM (2000) Long-term medical complications in patients surviving >or = 5 years after liver transplant. Transplantation 69:781–789

    PubMed  Google Scholar 

  5. Kishikawa H, Ichikawa Y, Yazawa K, Hanafusa T, Fukunishi T, Ebisui C, Okuyama A, Nagano S (1998) Malignant neoplasm in kidney transplantation. Int J Urol 5:521–525

    CAS  PubMed  Google Scholar 

  6. Stewart T, Tsai SCJ, Grayson H, Henderson R, Opelz G (1995) Incidence of de-novo breast cancer in women chronically immunosuppressed after organ transplantation. Lancet 346:796–798

    CAS  PubMed  Google Scholar 

  7. Schmähl D, Penn I (1991) Cancer in organ transplant recipients. In: Schmähl D, Penn I (eds) Organ transplantation. Springer, Heidelberg, pp 19–27

  8. Herman M, Weinstein T, Korsets A, Chagnac A, Ori Y, Zevin D, Malachi T, Gafter U (2001) Effect of cyclosporin A on DNA repair and cancer incidence in kidney transplant recipients. J Lab Clin Med 137:14–20

    Article  CAS  PubMed  Google Scholar 

  9. Euvrard S, Kanitakis J, Claudy A (2003) Skin cancers after organ transplantation. N Engl J Med 348:1681–1691

    Article  PubMed  Google Scholar 

  10. Penn I (1993) Neoplastic complications of transplantation. Semin Respir Infect 8:233–239

    CAS  PubMed  Google Scholar 

  11. Penn I (1993) Incidence and treatment of neoplasia after transplantation. J Heart Lung Transpl 12:S328–S336

    CAS  Google Scholar 

  12. Kyllonen L, Salmela K, Pukkala E (2000) Cancer incidence in a kidney-transplanted population. Transpl Int 13 [Suppl 1]:S394–S398

    Google Scholar 

  13. Birkeland SA (1997) De novo cancers complicating renal transplantation: experience in the Nordic countries. Ann Transplant 2:22–26

    CAS  PubMed  Google Scholar 

  14. Kapiteijn E, Marijnen CAM, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ (2001) Preoperative radiotherapy combined with total mesorectal excision for the resectable rectal cancer. N Eng J Med 345:638–646

    Article  CAS  Google Scholar 

  15. Rau B, Hohenberger P, Gellermann J, Hunerbein M, Hildebrandt B, Schneider U, Riess H, Wust P, Schlag PM (2002) T4 Rektumkarzinom. Operative and multimodal therapy. Chirurg 73:147–153

    Google Scholar 

  16. Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J (1994) Factors influencing the natural history of colorectal liver metastases. Lancet 343:1405–1410

    Article  CAS  PubMed  Google Scholar 

  17. Lutz J, Heemann U (2003) Tumours after kidney transplantation. Curr Opin Urol 13:105–109

    Article  PubMed  Google Scholar 

  18. Jacobsohn DA, Vogelsang GB (2002) Novel pharmacotherapeutic approaches to prevention and treatment of GVHD. Drugs 62:879–889

    CAS  PubMed  Google Scholar 

  19. Witzigmann H, Rhein T, Geissler F, Thiery J, Serr F, Tannapfel A, Uhlmann D, Metzner R, Hauss J (2002) Immunosuppression with sirolimus/tacrolimus combination in pancreas transplantation: 1-year results. Transplant Proc 34:3354–3356

    Article  CAS  PubMed  Google Scholar 

  20. Guba M, von Breitenbuch P, Steinbauer M, Koehl G, Flegel S, Hornung M, Bruns CJ, Zuelke C, Farkas S, Anthuber M, Jauch K-W, Geissler EK (2002) Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor. Nat Med 8:128–135

    CAS  PubMed  Google Scholar 

  21. Luan FL, Ding R, Sharma VK, Chon WJ, Lagman M, Suthanthiran M (2003) Rapamycin is an effective inhibitor of human renal cancer metastasis. Kidney Int 63:917–926

    Article  CAS  PubMed  Google Scholar 

  22. Starzl TE, Murase N, Abu-Elmagd K, et al (2003) Tolerogenic immuno-suppression for organ transplantation. Lancet 361:1502–1510

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, University Hospital, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    T. T. Zittel, C. F. R. Mehl, H. D. Becker & E. C. Jehle

  2. Department of Radio-oncology, University Hospital, Tübingen, Germany

    U. Reichmann

Authors
  1. T. T. Zittel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. F. R. Mehl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. Reichmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. D. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. C. Jehle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. T. Zittel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zittel, T.T., Mehl, C.F.R., Reichmann, U. et al. Treatment of advanced rectal cancer in a patient after combined pancreas–kidney transplantation. Langenbecks Arch Surg 389, 6–10 (2004). https://doi.org/10.1007/s00423-003-0422-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-003-0422-2

Keywords

Search

Navigation