title: Urothelial cancer after renal transplantation: an update.
abstract: According to the Australian and New Zealand Dialysis and Transplantation (ANZDATA) 2010 Annual Report, cancer is surpassing cardiovascular diseases as the leading cause of posttransplantation death. Skin cancer and posttransplantation lymphoproliferative disorder (PTLD) are 2 cancers in Western countries. However, urothelial cancer happens much more frequently among Chinese people. We reviewed our experience in Congress of the Asian Society of Transplantation (CAST) 2005, including 10 urothelial cancers, among 620 renal transplant recipients. In this report, we have presented our updated data. From July 1981 to May 2011, we performed 770 renal transplantations followed by graft and native kidney sonography annually even among asymptomatic cases using the protocol described in CAST 2005. During this period, 35 urothelial tumors were detected, ie, 25 new cases were identified in 6 years. These 35 cases included 7 cases with bilateral upper tract involvement and 5 of them with bladder tumors. Seven patients had bladder cancer alone. In 19 patients, 22 ureteral cancers included 1 that grew from the graft ureter, 17 (77.3%) patients showed hydronephrosis by sonography. We performed 13 bilateral nephroureterectomies; 2 were known to have bilateral upper tract cancer. Four of the other 11 were found to have insidious tumors. In contrast, 2 of the 15 initial unilateral nephroureterectomy patients underwent a subsequent contralateral nephroureterectomy due to a tumor. The pattern of urethral cancer in renal transplant recipients is thoroughly different, including female predominance, and a higher incidence of upper tract involvement. We emphasize the necessity of routine periodic sonographic survey even among asymptomatic patients for early detection of a urothelial tumor.
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Chiang
authors.forename: P-S
authors.initials: PS
authors.lastname: Yang
authors.forename: H-H
authors.initials: HH
authors.lastname: Wang
authors.forename: K-J
authors.initials: KJ
authors.lastname: Lin
authors.forename: K-L
authors.initials: KL
authors.lastname: Liu
authors.forename: S-H
authors.initials: SH
authors.lastname: Chu
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hsieh
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D014516:Ureteral Neoplasms / Q000150:complications*; D001749:Urinary Bladder Neoplasms / Q000150:complications*