title: De novo malignancies in renal transplant recipients: experience at a single center with 1882 transplant patients over 39 yr.
abstract: OBJECTIVE
  Cancers complicating organ allografts are a major cause of morbidity and mortality after renal transplantation. Different registries have described an overall three to eightfold increase in cancer risk compared with the general population. This retrospective study investigated the incidence and outcome of de novo malignancies following kidney transplantation in a single German kidney transplantation center.
  
  
  METHODS
  Between 1966 and 2005, 1882 patients underwent kidney transplantation at the Erlangen-Nuremberg kidney transplantation center. The incidence and types of post-transplant malignancies were retrospectively analyzed according to the patients' records and the database of the local cancer registry.
  
  
  RESULTS
  We identified 257 malignancies in 231 patients, an overall incidence of 13.7%. The mean follow-up time was 9.9 yr (range, 0.4-25.5 yr). The observed incidence data corresponded to a 12.1-fold increase in the overall risk of developing a malignant nonskin tumor compared with the nontransplanted population. Urinary tract malignancies represented the most frequent malignancies among the nonskin tumors (32.1%), followed by gastrointestinal tract (30.7%) and gynecological (14%) cancers. When we considered the duration from renal transplantation to tumor detection and tumor-specific survival, there was no difference between patients treated with or without a cyclosporine A-based regimen.
  
  
  CONCLUSIONS
  In our study, the overall risk of developing a post-transplant nonskin malignancy was 12.1-fold higher compared with the age-matched general population. Development of solid organ malignancies is one of the most frequent causes of morbidity and mortality in renal transplant recipients; thus, close tumor screening in patients after kidney transplantations is warranted.
authors.affiliation: Department of Urology, University Hospital Erlangen, Friedrich Alexander University, Erlangen-Nuremberg, Germany. hendrik.apel@uk-erlangen.de
authors.forename: Hendrik
authors.initials: H
authors.lastname: Apel
authors.forename: Karin
authors.initials: K
authors.lastname: Walschburger-Zorn
authors.forename: Lothar
authors.initials: L
authors.lastname: Häberle
authors.forename: Sven
authors.initials: S
authors.lastname: Wach
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Engehausen
authors.forename: Bernd
authors.initials: B
authors.lastname: Wullich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult