The outcome of post-transplant transitional cell carcinoma in 10 renal transplant recipients.
At our clinic we followed 320 renal transplant recipients, 16 of whom developed malignancies within 15 yr. Ten of the 16 malignancies were transitional cell carcinoma (TCC) of the urinary tract. The modalities of treatment included standard nephroureterectomy with bladder cuff removal for upper tract tumor, transurethral resection for superficial bladder tumor and partial cystectomy for one case of invasive bladder tumor, as requested by the patient. Post-operative intravesical chemotherapy with epirubicin, or immunotherapy with bacillus Calmette-Guerin (BCG) were carried out for superficial bladder tumor. Cyclosporine (CsA) used as post-transplant immunosuppressant was switched to low dose azathioprine (Aza) at the initial diagnosis of TCC. Four patients experienced tumor recurrence despite conversion of immunosuppressant from CsA to Aza. Among these 10 patients, five maintained normal renal function, three returned to hemodialysis without tumor recurrence, and two patients died of cancer.
Wang
Hwa-Ben
HB
Division of Urology, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung Hsien, Taiwan.
Hsieh
Hwei-Ho
HH
Chen
Yen-Ta
YT
Chiang
Chao-Yang
CY
Cheng
Yuan-Tso
YT
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000276:immunology / Q000628:therapy*; D011183:Postoperative Complications / Q000276:immunology / Q000628:therapy*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000276:immunology / Q000628:therapy*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine