Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management.

Autor: Griffith JJ; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Amin KA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Waingankar N; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Lerner SM; Transplant Surgery, Icahn School of Medicine at Mount Sinai, New York, NY., Delaney V; Transplant Surgery, Icahn School of Medicine at Mount Sinai, New York, NY., Ames SA; Transplant Surgery, Icahn School of Medicine at Mount Sinai, New York, NY., Badani K; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Palese MA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Mehrazin R; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2017 Nov; Vol. 17 (11), pp. 2775-2781. Date of Electronic Publication: 2017 Jun 27.
DOI: 10.1111/ajt.14366
Abstrakt: The objective of this review is to explore the available literature on solid renal masses (SRMs) in transplant allograft kidneys to better understand the epidemiology and management of these tumors. A literature review using PubMed was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Fifty-six relevant studies were identified from 1988 to 2015. A total of 174 SRMs in 163 patients were identified, with a mean tumor size of 2.75 cm (range 0.5-9.0 cm). Tumor histology was available for 164 (94.3%) tumors: clear cell renal cell carcinoma (RCC; 45.7%), papillary RCC (42.1%), chromophobe RCC (3%), and others (9.1%). Tumors were managed by partial nephrectomy (67.5%), radical nephrectomy (19.4%), percutaneous radiofrequency ablation (10.4%), and percutaneous cryoablation (2.4%). Of the 131 patients (80.3%) who underwent nephron-sparing interventions, 10 (7.6%) returned to dialysis and eight (6.1%) developed tumor recurrence over a mean follow-up of 2.85 years. Of the 110 patients (67.5%) who underwent partial nephrectomy, 3.6% developed a local recurrence during a mean follow-up of 3.12 years. The current management of SRMs in allograft kidneys mirrors management in the nontransplant population, with notable findings including an increased rate of papillary RCC and similar recurrence rates after partial nephrectomy in the transplant population despite complex surgical anatomy.
(© 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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