The high rate of de novo graft carcinomas in renal transplant recipients.
BACKGROUND
To investigate the incidence, the clinical characteristics and outcomes of renal graft carcinomas in the same renal transplant population.


METHODS
From April 1989 to April 2012, 1,037 consecutive renal transplantations were performed in our department. Data were collected prospectively in an extensively maintained database. For all recipients, monitoring consisted of clinical examination and an abdominopelvic CT scan or ultrasonography at least once a year.


RESULTS
After 1,037 renal transplantations, 48 men and 14 women (sex ratio 3:4) with a mean age of 54 years (25.1-78.9) were included for urological malignancies. Eight graft carcinomas were identified: 7 renal cell carcinomas (5 papillary carcinomas and 2 clear cell carcinomas of the renal graft) and 1 transitional cell carcinoma of the ureteral graft (incidence 0.78%). Nephron-sparing surgery was chosen for 5 patients with good outcomes. All graft renal cell carcinomas were classified as pT1a and the mean size of tumors was 28.4 mm (range 6-45). The 5-year specific survival rate was 100%. No recurrence was observed with a mean follow-up of 36.8 months (4.1-84.3).


CONCLUSIONS
Thus confirming an increased risk of de novo graft cancer, close monitoring of renal transplant recipients should be discussed with at least an abdominopelvic ultrasonography and PSA measurement once a year. Renal cell graft carcinomas seemed to be mostly small and of papillary type and low grade.
Urology and Transplantation Department, University Hospital Amiens, Amiens, France.
Ludovic
L
Viart
Nicolas
N
Surga
Sylvie
S
Collon
Maité
M
Jaureguy
Vincent
V
Elalouf
Xavier
X
Tillou
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D059351:Organ Sparing Treatments / Q000009:adverse effects; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014516:Ureteral Neoplasms / Q000453:epidemiology* / Q000601:surgery; D055815:Young Adult