Recurrence of Renal Cell Cancer After Renal Transplantation in a Multicenter French Cohort
| Autor: | Bruno Hurault de Ligny, Johnny Sayegh, Noëlle Cognard, Franck Le Roy, Cyril Garrouste, Philippe Gatault, Yann Le Meur, Antoine Thierry, Sophie Caillard, Marie Essig, Bruno Moulin, Sophie Girerd, Dany Anglicheau, Joseph Rivalan, Charlotte Colosio, Gabriel Choukroun |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Clinical Decision-Making 030232 urology & nephrology urologic and male genital diseases Risk Assessment Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Renal cell carcinoma Internal medicine medicine Carcinoma Humans Carcinoma Renal Cell Kidney transplantation Aged Retrospective Studies Transplantation Kidney business.industry Incidence Patient Selection Mortality rate Cancer Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Kidney Neoplasms Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Female France Neoplasm Recurrence Local business |
| Zdroj: | Transplantation. 102:860-867 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0000000000002009 |
| Popis: | BACKGROUND Renal cancer accounts for 3% of adult malignancies; renal cell carcinoma (RCC) represents 80% of all renal cancers, and is characterized by late recurrences. Recurrences after kidney transplantation are associated with a high mortality rate. We aimed to determine if recurrences are linked to tumor characteristics and to delays between diagnosis and transplantation. METHODS We retrospectively analyzed data from French kidney-transplanted patients with medical histories of pretransplant renal cancer, focusing on the most common histological subtypes: clear cell and papillary cancers. Characteristics of the tumors, patients, and kidney transplantations were documented, and posttransplant patient survival was analyzed. RESULTS Of 143 patients, 13 experienced cancer recurrence after kidney transplantation. The mean delay in recurrence was 3 ± 2.3 years posttransplantation, and the cumulative incidences of recurrence were 7.7% at 5 years and 14.9% at 10 years. The risk of recurrence was higher in patients with clear cell RCC (13% vs 0%, P = 0.015). There was no correlation between posttransplant recurrence and the interval before transplantation. Factors associated with a higher risk of cancer recurrence were histological clear cell RCC (P = 0.025), tumor stage pT2 (P = 0.002), and Fuhrman grade IV (P < 0.001). Recurrences were associated with a high mortality rate; 76.9% of patients with recurrences had died by the end of the follow-up period. CONCLUSIONS Recurrences of clear cell RCC are not uncommon after kidney transplantation and are associated with very poor prognoses. These results should be considered before listing patients with a history of renal cancer for transplantation. |
| Databáze: | OpenAIRE |
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