Renal cell carcinoma in patients with end-stage renal disease: a comparison of clinical significance in patients receiving hemodialysis and those with renal transplants.
OBJECTIVE
This review was undertaken to determine the clinical significance of renal cell carcinoma in the populations undergoing renal transplantation and those undergoing chronic dialysis.


METHODS
We reviewed all medical records of patients with renal cell carcinoma treated at our institutions over the last 10 years. From this review we identified 20 patients with end-stage renal disease and renal cell carcinoma. Patients' charts were reviewed to determine presenting features, tumor histologic type, and clinical outcome.


RESULTS
Seven patients had functioning renal transplants and 13 patients were on chronic maintenance hemodialysis. Ninety-two percent of the dialysis group had no metastatic disease and there were no deaths from renal cancer. In contrast, 53% of the transplant group did have metastatic disease and 2 patients died of renal cancer. Despite similar pathologic appearances of the tumors in these 2 groups, patients with renal cell carcinoma and renal transplant presented with higher-stage disease and had less favorable clinical courses.


CONCLUSIONS
Considering the morbidity of hemodialysis as well as the other comorbidities of this patient population, the clinical significance of renal cell carcinoma in patients undergoing chronic dialysis must be questioned. In contrast, renal cancer in the transplant population behaves aggressively and warrants careful attention both before and after renal transplantation.
Pope
J C
JC
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Koch
M O
MO
Bluth
R F
RF
D000328:Adult; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016030:Kidney Transplantation; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome