Renal Cell Carcinoma in Renal Transplantation: The Case for Surveillance

Bennett, William M.; Simonich, E.L.; Garre, Ana; McEvoy, Kevin M.; Farinola, Maryam A.; Batiuk, Thomas D.

doi:10.1016/j.transproceed.2017.06.031

Cited by 5 publications

(7 citation statements)

References 12 publications

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“…Post-KTx malignancy is a common cause of death [5,6,47,48,49,50,51] and RCC is the most common solid-organ malignancy in this population [52,53]. Due to the increased risk of RCC among ESRD patients [7,8], the Clinical Practice Guidelines Committee of the AST has suggested RCC screening in ESRD patients on dialysis for longer than 3 years [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Despite RCC screening prior to KTx, the findings from our study suggest that RCC can still occur post-KTx at a higher incidence (0.7%) than its reported incidence among ESRD patients (0.3%) [8]. In addition, studies have demonstrated that KTx recipients have a relative increased risk of five- to ten-fold for RCC compared with an age-matched general population, and that the majority of these tumors arise in the setting of acquired kidney cystic disease (AKCD) which develops with chronic renal failure [5,8,35,56,57,58,59,60,61,62,63,64]. Although RCC occurrence is more frequent in the native kidneys of KTx recipients, RCC can also occur in the renal allograft (incidence of 0.2%) [17,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…The long-term mortality rate is 48% to 82% lower in KTx recipients when compared to ESRD patients on the transplant waitlist [2,3]. However, due to immunosuppression, KTx patients are at a two-fold increased risk of developing malignancy in comparison to the general population [4,5,6]. Malignancies are among the top three leading causes of death in KTx recipients, following infection and cardiovascular complications [6].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality of Renal Cell Carcinoma after Kidney Transplantation: A Meta-Analysis

Chewcharat

Thongprayoon

Bathini

et al. 2019

JCM

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Background: The incidence and mortality of renal cell carcinoma (RCC) after kidney transplantation (KTx) remain unclear. This study's aims were (1) to investigate the pooled incidence/incidence trends, and (2) to assess the mortality/mortality trends in KTx patients with RCC. Methods: A literature search was conducted using the MEDLINE, EMBASE and Cochrane databases from inception through October 2018. Studies that reported the incidence or mortality of RCC among kidney transplant recipients were included. The pooled incidence and 95% CI were calculated using a random-effect model. The protocol for this meta-analysis is registered with PROSPERO; no. CRD42018108994. Results: A total of 22 observational studies with a total of 320,190 KTx patients were enrolled. Overall, the pooled estimated incidence of RCC after KTx was 0.7% (95% CI: 0.5–0.8%, I2 = 93%). While the pooled estimated incidence of de novo RCC in the native kidney was 0.7% (95% CI: 0.6–0.9%, I2 = 88%), the pooled estimated incidence of RCC in the allograft kidney was 0.2% (95% CI: 0.1–0.4%, I2 = 64%). The pooled estimated mortality rate in KTx recipients with RCC was 15.0% (95% CI: 7.4–28.1%, I2 = 80%) at a mean follow-up time of 42 months after RCC diagnosis. While meta-regression analysis showed a significant negative correlation between year of study and incidence of de novo RCC post-KTx (slopes = −0.05, P = 0.01), there were no significant correlations between the year of study and mortality of patients with RCC (P = 0.50). Egger's regression asymmetry test was performed and showed no publication bias in all analyses. Conclusions: The overall estimated incidence of RCC after KTX was 0.7%. Although there has been a potential decrease in the incidence of RCC post-KTx, mortality in KTx patients with RCC has not decreased over time.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Mortality of Renal Cell Carcinoma after Kidney Transplantation: A Meta-Analysis

Chewcharat

Thongprayoon

Bathini

et al. 2019

JCM

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“…The Kidney Disease Improving Global Outcomes (KDIGO) and American Society of Transplantation do not currently recommend regular screening for RCC in transplant recipients, while the European Association of Urology (EAU) guidelines recommend annual RCC screening with ultrasound [1]. Bennet et al [9] conducted a prospective RCC screening study where new KTRs received ultrasound screening at 6 months and 1 year. 13.3% of ultrasound examinations, or 18 total out of 135, in their study were abnormal, with 10.4%, or 14, of the studies yielding a diagnosis of acquired cystic kidney disease, a known risk factor for acquiring RCC.…”

Section: Discussionmentioning

confidence: 99%

“…13.3% of ultrasound examinations, or 18 total out of 135, in their study were abnormal, with 10.4%, or 14, of the studies yielding a diagnosis of acquired cystic kidney disease, a known risk factor for acquiring RCC. 2.9%, or 4, of the studies detected a solid lesion, of which 3 were eventually biopsy proven to be RCC [9]. Kiss et al [10] conducted a retrospective study of an annual abdominal ultrasound screening protocol at their institution, which resulted in 88 lesions (6%) being detected; 14 of these (16% of the total lesions) went on to be biopsy-confirmed RCC.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Graft Survival of Kidney Transplant Recipients with Renal Cell Carcinoma

et al. 2020

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Background: The incidence of renal cell carcinoma (RCC) is higher in kidney transplant recipients (KTRs) compared to the general population. However, the risk factors and outcomes based on the diagnosis of RCC after kidney transplantation are limited. Methods: We analyzed risk factors for the development of RCC in KTRs transplanted at our institution between 1994 and 2016. We compared the incidence of graft failure and mortality in KTRs with RCC to matched controls using 5:1 event density sampling. Identifying the risk factors of RCC and patient and graft survival were outcomes of interest. Results: There were 4,178 KTRs performed at our institution during the study period, and 51 patients were diagnosed with RCC. Recipients were followed until graft failure or death. We did not identify commonly looked at baseline characteristics associated with the risk of RCC. Comparing KTRs with RCC to matched controls, RCC patients were younger (47.5 vs. 49.6 years, p < 0.01), received basiliximab induction more commonly (p = 0.01), had hypertension and glomerulonephritis as causes of end-stage renal disease (p = 0.01), and were more likely to be smokers (p < 0.01). RCC was significantly associated with death-censored graft failure (adjusted hazard ratio [HR]: 1.76; 95% CI: 1.02–3.03; p = 0.04) but not patient death (adjusted HR: 0.95; 95% CI: 0.50–1.83; p = 0.89). Conclusion: In our experience, RCC had a detrimental impact on graft survival among KTRs, highlighting the potential benefit of early diagnosis and optimal immunosuppression management in optimizing graft survival.

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Renal cell carcinoma in kidney transplant recipients: incidence, trends, clinical management & outcomes

et al. 2023

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Renal Cell Carcinoma in Renal Transplantation: The Case for Surveillance

Cited by 5 publications

References 12 publications

Incidence and Mortality of Renal Cell Carcinoma after Kidney Transplantation: A Meta-Analysis

Incidence and Mortality of Renal Cell Carcinoma after Kidney Transplantation: A Meta-Analysis

Characteristics and Graft Survival of Kidney Transplant Recipients with Renal Cell Carcinoma

Renal cell carcinoma in kidney transplant recipients: incidence, trends, clinical management & outcomes

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