De Novo Renal Cell Carcinoma of Native Kidneys in Renal Transplant Recipients: A Single-center Experience

Moris, Demetrios; Kakavia, Kyriaki; Argyrou, Chrysoula; Garmpis, Nikolaos; Bokos, John; Vernadakis, Spiridon; Diles, Konstantinos; Sotirchos, Georgios; Boletis, John; Zavos, G.

doi:10.21873/anticanres.11376

Cited by 14 publications

(17 citation statements)

References 42 publications

(61 reference statements)

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“…While the exact etiology of the increased risk of RCC in KTx remains unclear, it is likely linked to the immunosuppressed state [4]. Reported risk factors for post-KTx RCC include older age, male sex, African descent, excess body weight, smoking, hypertension, history of acquired cystic kidney disease (ACKD), previous RCC prior to KTx, and longer pre-transplant dialysis duration [3,6,18,23,29,31,34,35,65,66,67]. Studies have shown that causes of ESRD before KTx may also affect the incidence of post-KTx RCC [14,32,35].…”

Section: Discussionmentioning

confidence: 99%

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%

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

Chewcharat

Thongprayoon

Bathini

et al. 2019

JCM

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“…RCC in patients who have undergone kidney transplantation occurs more often in the native kidney than in the renal allograft, although the reasons for this are not fully understood; risk factors that have been suggested including the type of immunosuppressant and the duration of immunosuppressive treatment, chronic native kidney disease, recipient’s age, and pre-transplantation dialysis duration [16]. While the etiology of increased risk of RCC remains elusive, and data are lacking on epidemiology and management of this solid renal mass in both native and allograft kidneys [12], the chronic immunosuppressed state of transplantation patients has been suggested to be an associated factor [17].…”

Section: Discussionmentioning

confidence: 99%

New-Onset Diabetes After Renal Transplantation (NODAT): Is It a Risk Factor for Renal Cell Carcinoma or Renal Failure?

Nie¹,

Wang²,

Zhao³

et al. 2019

Ann Transplant

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BackgroundDiabetes mellitus (DM) is a risk factor for renal failure and possibly for renal cell carcinoma (RCC). Post-transplantation DM occurs frequently after solid organ transplantation. We investigated whether new-onset diabetes after renal transplantation (NODAT) is a risk factor for RCC or renal failure.Material/MethodsData of 96,699 discharged patients with and without NODAT were extracted from the 2005–2014 Nationwide Inpatient Sample (NIS) database, after excluding patients with DM diagnosed at least 1 year prior to renal transplantation. Main outcomes were RCC diagnosis less than 1-year post-transplantation, RCC stage, and renal failure. Univariate and multivariate regression analyses were performed to identify demographic and clinical factors associated with post-transplantation RCC or renal failure.ResultsSignificant differences were found in age and race between patients with and without NODAT (both P<0.001). The renal failure rate was 0.8% (n=1) in NODAT patients and 0.3% (n=314) in those without NODAT. Older age (OR, 1.030; 95% CI: 1.023 to 1.036), male (OR, 1.872; 95% CI: 1.409 to 2.486), Black (OR, 2.199; 95% CI: 1.574 to 3.071) and hospitalization in urban teaching hospitals were associated with increased risk of RCC.ConclusionsAnalysis of over 90,000 NIS hospitalizations with diagnosis-coded kidney transplantation suggested that NODAT may not be an independent risk factor for RCC and renal failure.

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“…Although the risk of RCC in native kidneys among renal allograft recipients is 15-100 times higher than in the general population [ 3 ], de novo RCC in renal allograft is a very rare event. In 1995, Penn et al [ 7 ] from the CTTR (Cincinnati Transplant Tumor Registry) reported 24 cases among 7596 cancers in kidney allograft recipients from 1968 until 1994.…”

Section: Discussionmentioning

confidence: 99%

“…Four tumors were clear cell RCC and one was a papillary RCC. Patients from all these studies had an excellent survival after simple surgical treatment, whether after nephron sparing surgery or graft nephrectomy [ 3 – 6 ]. CDC of Bellini as observed in our patient is an uncommon variant of RCC, which represents less than 1% of all RCC.…”

Section: Discussionmentioning

confidence: 99%

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BK virus-associated collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft recipient

et al. 2018

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BK polyomavirus (BKV) nephropathy is a major concern in renal transplantation. Its main consequence is graft loss, which occurs in more than 50% of the cases. De novo renal cell carcinoma in renal allograft is a very rare event. Most of these tumors are papillary or clear cell carcinomas. We report herein the first case of collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft adult recipient. Collecting duct carcinoma occurs long after the cure of a BKV nephropathy. At this time, BKV viremia and viruria were negative as well as the immunostaining for SV40 in the non-tumor kidney. The viral oncoprotein Tag persists only in the tumor cells. To preserve pancreas graft function, we maintained immunosuppression levels. After a 9-months follow-up, the evolution was free from clinical and radiological progression. The oncogenic role of BKV remains controversial in human cancers. However, strong experimental data have shown an association between BKV infection and urologic neoplasms. Further works might precise the exact role of polyomaviruses in renal carcinogenesis. In the meantime, clinical vigilance for early diagnostic of these tumors is mandatory after BKV nephropathy.

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De Novo Renal Cell Carcinoma of Native Kidneys in Renal Transplant Recipients: A Single-center Experience

Cited by 14 publications

References 42 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

New-Onset Diabetes After Renal Transplantation (NODAT): Is It a Risk Factor for Renal Cell Carcinoma or Renal Failure?

BK virus-associated collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft recipient

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