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Renal cell carcinoma in kidney transplant recipients: incidence, trends, clinical management & outcomes

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Objective

To describe the incidence, characteristics, clinical management, and outcomes of renal cell carcinoma (RCC) among a large, single-centre cohort of kidney transplant recipients (KTR).

Methods

We conducted an observational cohort study looking at KTR transplanted between January 2000-December 2017 (n = 2443) with ≥ 1 year of follow-up. Simultaneous kidney/pancreas transplants were excluded. The Kaplan–Meier product-limit method was used to determine the incidence of RCC. Characteristics and management of RCC were examined using descriptive statistics. Risk factors and clinical outcomes were analyzed using Cox regression models.

Results

The incidence of RCC among our cohort was 0.32 per 100 person-years, 2.1% of all KTRs. Almost half (47.1%) of cases occurred within 4 years post-transplant. The majority of cases were T1a (86.3%), clear-cell (45.1%), and in the native kidney (80.4%). KTR diagnosed with RCC had a twofold higher incidence of other malignancies versus KTR without RCC. Overall mortality, but not cancer-specific mortality, at 2- and 5-years post-transplant was threefold higher among KTR with RCC than those without.

Conclusions

Incidence of RCC among our KTR was slightly higher than the general population; majority of cases occur in the native kidneys and are low stage, low grade. Indolent histologic variants were more common than the general population. KTR with RCC had a higher incidence of other malignancies. Overall, but not cancer-specific, mortality was higher among KTRs diagnosed with RCC.

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Data availability

De-identified data is available for review upon request.

Abbreviations

CI:

Confidence interval

ESRD:

End-stage renal disease

HR:

Hazard ratio

IQR:

Interquartile range

KT:

Kidney transplantation

KTR:

Kidney transplant recipients

RFA:

Radiofrequency ablation

RCC:

Renal cell carcinoma

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Funding

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Author information

Author notes

  1. Michelle Minkovich and Rebecca Bic Kay Wong have contributed equally to this work.

  2. S. Joseph Kim and Jason Y. Lee have jointly directed this work.

Authors and Affiliations

  1. Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada

    Michelle Minkovich, Rebecca Bic Kay Wong, Olusegun Famure, Yanhong Li, S. Joseph Kim & Jason Y. Lee

  2. Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada

    S. Joseph Kim

  3. Department of Surgery, Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada

    Jason Y. Lee

Authors
  1. Michelle Minkovich
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  2. Rebecca Bic Kay Wong
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  3. Olusegun Famure
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  4. Yanhong Li
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  5. S. Joseph Kim
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Contributions

MM: Research design, data collection and management, interpretation of the results, manuscript writing. RBKW: Research design, data collection and management, Interpretation the results, manuscript writing. OF: Study conception, research design, interpretation of the results, manuscript writing. YL: Statistical analysis, interpretation of the results. SJK: Study conception, research design, statistical analysis, interpretation of the results, manuscript writing. JL: Study conception, research design, interpretation of the results, manuscript writing.

Corresponding author

Correspondence to Jason Y. Lee.

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Minkovich, M., Wong, R.B.K., Famure, O. et al. Renal cell carcinoma in kidney transplant recipients: incidence, trends, clinical management & outcomes. World J Urol 41, 2389–2395 (2023). https://doi.org/10.1007/s00345-023-04495-9

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  • DOI: https://doi.org/10.1007/s00345-023-04495-9

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