title: Biopsy-confirmed de novo renal cell carcinoma (RCC) in renal grafts: a single-centre management experience in a 2396 recipient cohort.
abstract: OBJECTIVE
  To study the natural history of renal cell carcinoma (RCC) development in renal grafts and their management.
  
  
  METHODS
  We report a single-centre series of de novo RCC in allografts from a cohort of 2396 consecutive renal transplant recipients.
  
  
  RESULTS
  In all, 17 RCCs were detected in 12 patients, representing 0.5% of kidney recipients. The mean patient age was 55 years and the time to RCC diagnosis since transplantation was 13 years. The mean diameter of the RCC was 23 mm. Biopsies were taken in all cases. Concordance between biopsy and surgical specimens was 100% for nuclear grade and pathological type. Four graft removals were performed and six patients underwent nephron-sparing surgery (NSS). Two cryoablations were performed. Overall, nine papillary RCC, five clear cell carcinomas, and one chromophobe cell carcinoma were removed surgically. The mean follow-up was 43 months. One local recurrence was reported in a patient treated by NSS.
  
  
  CONCLUSIONS
  Our findings support evidence that radiological screening of kidney recipients allows the detection of small tumours for which a conservative management by NSS or non-surgically destructive techniques can be proposed with mid-term oncological safety. Systematic tumour biopsy may help in the management and treatment decision. Several questions remain unanswered such as the importance of mammalian target of rapamycin inhibitors in the chemoprevention of the recurrence and the genetic cell origin of RCC in renal grafts.
authors.affiliation: Service d'Urologie, Département DUNE, IUH Université Paris Denis Diderot Hôpital Saint-Louis, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.forename: Damien
authors.initials: D
authors.lastname: Chambade
authors.forename: Paul
authors.initials: P
authors.lastname: Meria
authors.forename: François
authors.initials: F
authors.lastname: Gaudez
authors.forename: Edouard
authors.initials: E
authors.lastname: Tariel
authors.forename: Jérôme
authors.initials: J
authors.lastname: Verine
authors.forename: Cédric
authors.initials: C
authors.lastname: De Bazelaire
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Peraldi
authors.forename: Denis
authors.initials: D
authors.lastname: Glotz
authors.forename: François
authors.initials: F
authors.lastname: Desgrandchamps
authors.forename: Pierre
authors.initials: P
authors.lastname: Mongiat-Artus
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D016896:Treatment Outcome