title: Significant risk factors for occurrence of cancer after renal transplantation: a single center cohort study of 1265 cases.
abstract: 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.
authors.affiliation: Department of Nephrology, Dialysis, and Renal Transplantation, Hôpital Nord, CHU de Saint-Etienne, Saint-Etienne, France.
authors.forename: W
authors.initials: W
authors.lastname: Bichari
authors.forename: M
authors.initials: M
authors.lastname: Bartiromo
authors.forename: H
authors.initials: H
authors.lastname: Mohey
authors.forename: A
authors.initials: A
authors.lastname: Afiani
authors.forename: A
authors.initials: A
authors.lastname: Burnot
authors.forename: N
authors.initials: N
authors.lastname: Maillard
authors.forename: C
authors.initials: C
authors.lastname: Sauron
authors.forename: D
authors.initials: D
authors.lastname: Thibaudin
authors.forename: M
authors.initials: M
authors.lastname: Mehdi
authors.forename: C
authors.initials: C
authors.lastname: Mariat
authors.forename: E
authors.initials: E
authors.lastname: Alamartine
authors.forename: F
authors.initials: F
authors.lastname: Berthoux