Abstract
Objective
After solid organ transplantation, risk of cancer varies significantly based on cancer type. In this study, we determine the incidence of urothelial cancers (bladder and kidney) after renal transplantation from a single high-volume transplantation institution. In addition, we analyze the risk factors and review outcomes from the patients.
Materials and methods
We performed a retrospective review of all patients in the University of Alabama at Birmingham (UAB) transplant database to identify all patients who received renal transplants at UAB between January 1, 1990, and January 1, 2010. We further identified transplant patients diagnosed with bladder, urothelial of other cancers in the same time period. We also examined tumor-specific variables such as presentation, clinical and pathologic staging, treatment type, recurrence, progression, interval to recurrence and progression, cancer-specific mortality, and interval from time to diagnosis to death.
Results
Review of the transplant database confirmed 5,920 renal transplants. Thirteen patients underwent the diagnosis of urothelial cancer, providing an incidence of 0.2%. Eight patients had bladder cancer for an incidence of 0.13%, compared to an incidence of 0.02% among the general population. Patients diagnosed with bladder cancer after renal transplantation were younger than those in the general population and frequently present with more advanced and aggressive disease.
Conclusions
Patients are at an elevated risk of urothelial cancers after renal transplantation probably from immune suppression.
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References
Kasiske B, Snyder J, Gilbertson D, Wang C (2004) Cancer after kidney transplantation in the United States, American. J Transplant 4(6):905–913
Vajdic C, McDonald S, McCredie M et al (2006) Cancer incidence before and after kidney transplantation. JAMA 296:2823
Stewart J, Vajdic C, van Leeuwen M et al (2009) The pattern of excess cancer in dialysis and transplantation. Nephol Dial Transplant 24:3225
Birkeland S, Lokkegaard H, Storm H (2000) Cancer risk in patients on dialysis and after renal transplantation. Lancet 355:1886
Grulich A, van Leeuwen M, Falster M et al (2007) Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 370:59
SEER datafile (2010) Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer EJ, Stinchcomb DG, Edwards BK (eds). SEER Cancer Statistics Review, 1975–2007, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2007/, based on November 2009 SEER data submission, posted to the SEER web site
Master V, Meng M, Grossfeld G, Carroll P et al (2004) Treatment and outcome of invasive bladder cancer in patients after renal transplantation. J Urology 171:1085
Li X, Xing N, Wang Y et al (2008) Transitional cell carcinoma in renal transplant recipients: a single center experience. Int J Urology 15:53
Buzzeo B, Heisey D, Messing E (1997) Bladder cancer in renal transplant recipients. Urology 50:525
diCapua Sacoto C, Lujan Marco S, Jimenez Cruz J et al (2010) De nova urologic neoplasms in kidney transplant patients: experience in 1.751 patients. Actas Urolo Esp 34(1):88–94
Elkentaoui H, Robert G, Pastecier G et al (2010) Therapeutic management of de nova urologic malignancy in renal transplant recipients: the experience of the French Department of Urology and Kidney Transplantation from Bordeaux. Urology 75:126
Kamal M, Soliman S, Shokeir A et al (2008) Bladder carcinoma among live-donor renal transplant recipients: a single centre experience and a review of the literature. BJU Int 101:30
Ehdaie B, Stukenborg G, Theodorescu D (2009) Renal transplant recipients and patients with end stage renal disease present with more advanced bladder cancer. J Urology 182:1482
Cooke T, Soloway M, Manoharan M et al (2007) Orthotopic ileal neobladder reconstruction after renal transplant. Am J Transplant 7:2630–2633
Besarani D, Cranston D (2007) Urologic malignancy after renal transplantation. BJU Int 100:502
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Cox, J., Colli, J.L. Urothelial cancers after renal transplantation. Int Urol Nephrol 43, 681–686 (2011). https://doi.org/10.1007/s11255-011-9907-z
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DOI: https://doi.org/10.1007/s11255-011-9907-z