Journal List > J Korean Soc Transplant > v.27(3) > 1034398

J Korean Soc Transplant. 2013 Sep;27(3):121-127. Korean.
Published online September 26, 2013.  https://doi.org/10.4285/jkstn.2013.27.3.121
Copyright © 2013 The Korean Society for Transplantation
Clinical Characteristics and Risk Factors for Renal Cell Carcinoma after Kidney Transplantation
Yun Tae Jung, M.D.,1 Jung Jun Lee, M.D.,1,2 Su Hyung Lee, M.D.,1,2 A-Lan Lee, M.D.,1,2 Kyu Ha Huh, M.D.,1,2 Myoung Soo Kim, M.D.,1,2 Soon Il Kim, M.D.,1,2 Yu Seun Kim, M.D.,1,2 and Dong Jin Joo, M.D.1,2
1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
2Department of Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (Email: djjoo@yuhs.ac )
Received July 31, 2013; Accepted August 29, 2013.

Abstract

Background

The occurrence of malignancy following kidney transplantation has been estimated three to five times the incidence compared to that of the general population. It is estimated that particularly in renal cell carcinoma (RCC), the relative risk increases. The aim of this study was to analyze the characteristics, risk factors, and prognosis of RCC following kidney transplantation.

Methods

Total number of 3,272 kidney recipients who underwent transplantation from April 1979 to December 2012 and patients who had RCC following kidney transplantation were retrospectively reviewed and analyzed.

Results

We found that among 232 cases of posttransplant malignancies, 25 recipients were diagnosed with RCC. We have observed in our study that it took an average of 175.2±71.0 months to develop RCC after their first kidney transplantation. However, with longer follow up period, interval incidence of RCC increased. Fourteen patients (56%) were diagnosed with RCC 15 years after transplantation. We also found that with reference to the risk factor analysis for posttransplant RCC, the long-term follow-up period was the only independent risk factor. In our study, 21 patients with RCC were treated with radical nephrectomy. Of them, 16 patients survived, and four RCC-related deaths occurred. Furthermore, the patient survival rate of RCC recipients was lower than that of the nonmalignancy group despite the graft survival rate were not different.

Conclusions

We conclude that the incidence of RCC increased in a time-dependent manner following kidney transplantation. Therefore, we strongly recommend the procedure of regular-interval screening for the patients who are on compulsive long-term immunosuppression.

Keywords: Kidney transplantation; Renal cell carcinoma; Malignancy

Figures


Fig. 1
Interval incidence of renal cell carcinoma after kidney transplantation. Interval incidence of posttransplant renal cell carcinoma (RCC) increased time-dependently. Also, as the duration from starting dialysis increased, interval incidence of postdialysis RCC increased. Abbreviation: Post-Tx, posttransplant.
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Fig. 2
Renal cell carcinoma (RCC) occurrence according to the patients' survival.
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Fig. 3
(A, B) Graft and patient survival rates. Patient survival rates of the renal cell carcinoma (RCC) patients were worse than the patients without malignancy but graft survival rates were not different between the two groups.
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Tables


Table 1
Clinical manifestations of posttransplant renal cell carcinoma patients
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Table 2
Comparison between renal cell carcinoma and nonmalignancy patients
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Table 3
Risk factor analysis for posttransplant renal cell carcinoma
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