Significant risk factors for occurrence of cancer after renal transplantation: a single center cohort study of 1265 cases.
Occurrence of cancer after renal transplantation remains a major problem, and the second cause of death. We performed a retrospective analysis of first cancer, first skin cancer, and first organ cancer (including posttransplant lymphoproliferative disease [PTLD]) among 1265 cases from 1979 to 2006. The occurrence of cancer was clearly a time-dependent event justifiying the use of Kaplan-Meier survival and Cox regression methods. The 10-year cumulative incidences of first cancer, first skin cancer, and first organ cancer were 24.6%, 14.5%, and 14.5%, respectively. Recipient age was a major, independent risk factor for the 3 endpoints with a 6% increased relative risk for each year increment (P < .0001). Female gender was also a major, independent risk factor, but only for skin cancer (P = .0002). We could not demonstrate any difference between the immunosuppressive drugs used for induction or maintenance therapy, especially between antithymocyte globulin (ATG) vs anti-CD25, cyclosporine vs tacrolimus, and azathioprine vs mycophenolate mofetil. Large cohorts are needed with strict stratifications for recipient age and gender to detect any difference, if any, among the drugs.
Bichari
W
W
Department of Nephrology, Dialysis, and Renal Transplantation, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne, France.
Bartiromo
M
M
Mohey
H
H
Afiani
A
A
Burnot
A
A
Maillard
N
N
Sauron
C
C
Thibaudin
D
D
Mehdi
M
M
Mariat
C
C
Alamartine
E
E
Berthoux
F
F