title: De Novo Solid Tumors After Kidney Transplantation: Is It Time for a Patient-Tailored Risk Assessment? Experience From a Single Center.
abstract: BACKGROUND
  Progress in immunosuppressive therapy and perioperative techniques has improved the survivals of both grafts and patients. The patient, however, is exposed to the risks of aging and side effects of immunosuppression. De novo tumors are the 2nd cause of death in the organ transplant population. The aim of this study was to evaluate whether the current accepted guidelines for the pre-transplantation study and the post-transplantation follow-up have been effective, in our kidney transplant population, regarding early detection and treatment, improving prognosis, and reducing mortality of some curable neoplastic diseases.
  
  
  METHODS
  We considered de novo tumors in kidney transplant patients from 1995 to 2010 (n = 636) excluding hematologic and nonmelanoma skin tumors from our study.
  
  
  RESULTS
  There were 64 de novo tumors in 59 patients out of 636 kidney transplant patients; 29.68% were urogenital cancer, 26.56% gastrointestinal cancer, 12.5% melanoma, 6.25% lung cancer, 6.25% biliopancreatic cancer, 4.68% visceral Kaposi sarcoma, 4.68% breast cancer, 4.68% thyroid cancer, 1 pleural mesothelioma, 1 meningioma, 1 merkeloma. Twenty patients died because of cancer. Ten patients had a late de novo tumor diagnosis, when the stage of tumor was advanced and not suitable for curative treatment.
  
  
  CONCLUSIONS
  Because of the increased neoplastic risk, we consider it mandatory to carry out a meticulous screening and to implement pre-transplantation study concerning this increased neoplastic risk population to detect a subgroup of patients presenting the highest risk to improve their outcome.
authors.affiliation: Surgical Oncology, IRCCS Centro di Riferimento Oncologico, Aviano (PN), Italy. Electronic address: arossetto@cro.it.
authors.forename: A
authors.initials: A
authors.lastname: Rossetto
authors.affiliation: Nephrology, Dialysis, and Renal Transplantation, AOU S Maria della Misericordia, Udine, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Tulissi
authors.affiliation: Surgical Oncology, IRCCS Centro di Riferimento Oncologico, Aviano (PN), Italy.
authors.forename: F
authors.initials: F
authors.lastname: De Marchi
authors.affiliation: Nephrology, Dialysis, and Renal Transplantation, AOU S Maria della Misericordia, Udine, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Gropuzzo
authors.affiliation: Nephrology, Dialysis, and Renal Transplantation, AOU S Maria della Misericordia, Udine, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Vallone
authors.affiliation: General Surgery and Transplantation, University Hospital of Udine, Udine, Italy.
authors.forename: G L
authors.initials: GL
authors.lastname: Adani
authors.affiliation: General Surgery and Transplantation, University Hospital of Udine, Udine, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.affiliation: General Surgery and Transplantation, University Hospital of Udine, Udine, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Lorenzin
authors.affiliation: Nephrology, Dialysis, and Renal Transplantation, AOU S Maria della Misericordia, Udine, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Montanaro
authors.affiliation: General Surgery and Transplantation, University Hospital of Udine, Udine, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*