Recommandations françaises du Comité de transplantation de l’association française d’urologie (CTAFU) : Carcinome à cellules rénales du transplant rénal
| Autor: | Arnaud Doerfler, N. Szabla, T. Culty, Marc-Olivier Timsit, T. Bessede, Gregory Verhoest, A. Mejean, G. Defortescu, Thomas Prudhomme, Karim Bensalah, Pierre Bigot, Xavier Tillou |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry Urology medicine.medical_treatment Population 030232 urology & nephrology Renal function urologic and male genital diseases medicine.disease Asymptomatic Nephrectomy 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Tumor stage Medicine Stage (cooking) medicine.symptom business education Clear cell |
| Zdroj: | Progrès en Urologie. 31:24-30 |
| ISSN: | 1166-7087 |
| Popis: | OBJECTIVE To propose recommendations for the management of renal cell carcinomas (RCC) of the renal transplant. METHOD Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU to evaluate prevalence, diagnosis and management of RCC arousing in the renal transplant. References were assessed according to a predefined process to propose recommendations with levels of evidence. RESULTS Renal cell carcinomas of the renal transplant affect approximately 0.2% of recipients. Mostly asymptomatic, these tumors are mainly diagnosed on a routine imaging of the renal transplant. Predominant pathology is clear cell carcinomas but papillary carcinomas are more frequent than in general population (up to 40-50%). RCC of the renal transplant is often localized, of low stage and low grade. According to tumor characteristics and renal function, preferred treatment is radical (transplantectomy) or nephron sparing through partial nephrectomy (open or minimally invasive approach) or thermoablation after percutaneous biopsy. Although no robust data support a switch of immunosuppressive regimen, some authors suggest to favor the use of mTOR inhibitors. CTAFU does not recommend a mandatory waiting time after transplantectomy for RCC in candidates for a subsequent renal tranplantation when tumor stage |
| Databáze: | OpenAIRE |
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