title: Neoplasm incidence in simultaneous pancreas and kidney transplantation: a single-center analysis.
abstract: BACKGROUND
  Long-term immunosuppression is associated with an increased rate of cancer. The aim of this study was to analyze the incidence of newly diagnosed tumors in simultaneous kidney and pancreas transplantation (SPKT).
  
  
  METHODS
  We retrospectively analyzed the incidence of a neoplasm among 360 diabetic subjects who consecutively underwent SPKT from 1985 to August 2010 in a single institution. Data were retrieved from the institutional registry. We evaluated the nature of all newly diagnosed malignant tumors, including posttransplantation lymphoproliferative disease (PTLD), to compare Kaplan-Meier survival rates with those of patients free of a neoplasm.
  
  
  RESULTS
  The median follow-up was 8 years; the overall 5-year patient survival was 84%. In 25 patients the tumors were malignant. Almost one-fourth of the cancers represented skin tumors (3 squamous cell and 4 basal cell carcinomas). PTLD was diagnosed in 5 recipients. The cumulative survival of patients with malignancies was significantly lower than that in recipients without cancer (8-year survival by 38% vs 70%; P < .001). The mean (±SD) time to diagnosis was 6 ± 3 years. Since 2004, the 12 recipients with malignancy who were switched to sirolimus at the time of diagnosis showed survivals that were not apparently better than those who remained on the established immunosuppression (46% vs 55%; P = .71).
  
  
  CONCLUSIONS
  The risk of neoplasm development was similar to that reported by other centers. Recipients of SPKT show higher incidence of cancer, though their overall survival is still significantly better than in those usually remaining on dialysis.
authors.affiliation: Institute for Clinical and Experimental Medicine, Prague, Czech Republic. pegi@ikem.cz
authors.forename: P
authors.initials: P
authors.lastname: Girman
authors.forename: K
authors.initials: K
authors.lastname: Lipar
authors.forename: M
authors.initials: M
authors.lastname: Kocik
authors.forename: J
authors.initials: J
authors.lastname: Kriz
authors.forename: T
authors.initials: T
authors.lastname: Marada
authors.forename: F
authors.initials: F
authors.lastname: Saudek
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000209:etiology*; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010182:Pancreatic Diseases / Q000150:complications*; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents