Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

Autor: Wilfried Gwinner, Alon Goldis, Harald Schrem, Marlene Kurok, Maren Dreier, Moritz Kleine, Valentin Schneider, Alexander Kaltenborn, Marc Barthold, Markus Winny, Jan Liebeneiner, Jürgen Klempnauer
Rok vydání: 2016
Předmět:
Male
Melanomas
030232 urology & nephrology
lcsh:Medicine
Lung and Intrathoracic Tumors
Prostate cancer
0302 clinical medicine
Endocrinology
Risk Factors
Thymic Tumors
Neoplasms
Epidemiology of cancer
Medicine and Health Sciences
Renal Transplantation
Medicine
Young adult
lcsh:Science
Child
Endocrine Tumors
Kidney transplantation
Multidisciplinary
Cancer Risk Factors
Prostate Cancer
Prostate Diseases
Middle Aged
surgical procedures
operative
Oncology
030220 oncology & carcinogenesis
Epidemiological Monitoring
Female
Risk assessment
Research Article
Adult
medicine.medical_specialty
Adolescent
Endocrine Disorders
Urology
Surgical and Invasive Medical Procedures
Risk Assessment
Carcinomas
Disease-Free Survival
Urinary System Procedures
03 medical and health sciences
Young Adult
Diagnostic Medicine
Cancer Detection and Diagnosis
Diabetes Mellitus
Humans
Intensive care medicine
Aged
Retrospective Studies
Transplantation
business.industry
lcsh:R
Case-control study
Renal Cell Carcinoma
Cancer
Cancers and Neoplasms
Retrospective cohort study
Organ Transplantation
medicine.disease
Kidney Transplantation
Surgery
Genitourinary Tract Tumors
Case-Control Studies
Metabolic Disorders
lcsh:Q
Thyroid Carcinomas
business
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 7, p e0158732 (2016)
ISSN: 1932-6203
Popis: Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p
Databáze: OpenAIRE
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