Transitional Cell Carcinoma in Renal Transplant Recipients

Abstract

Renal transplantation (RTx) recipients have a high incidence of cancer, including transitional cell carcinoma (TCC). Posttransplantation urologic malignancies still present a challenge for transplant surgeons. Using the Dialysis and Transplant Registry of Taichung Veterans General Hospital, a total of 55 cancers were diagnosed in 52 RTx recipients between May 1983 and September 2001. Of these, 24 RTx recipients developing TCC were identified and presented the distinctly high percentage (43.6%) of TCC that were malignancies after RTx in Taiwan. The mean time between transplantation and initial diagnosis was 46 months in our series. Painless hematuria with pyuria is the most common mode of presentation. Transitional cell carcinoma of RTx recipients had multiple foci. Moreover, synchronous TCC in bilateral upper urinary tracts were confirmed in 9 (41%) recipients. The pathologic status of disease is invasive at diagnosis (pTa: 2, pT1: 7, pT2: 4, pT3: 6, pT4: 2, graft metastasis: 1 and distant metastasis: 2). Disseminated metastasis occurred in 6 recipients, all of whom died of their disease within 16 months. Five recipients received adjuvant chemotherapy and retained stable renal function. We conclude that RTx recipients have a markedly increased incidence of TCC in Taiwan, and that prophylactic bilateral nephroureterectomy of native kidneys with bladder cuff excision can be performed simultaneously in RTx recipients with TCC.

Liver resection for hepatocellular carcinoma in patients who have undergone prior renal transplantation

“…With improvements in surgical techniques and immunosuppressive drugs, renal transplantation is now the most common option for end stage renal failure (ESRD) to prolong survival and improve quality of life [1][2][3][4][5]. However, a higher incidence of subsequent malignant disease may occur after renal transplantation [1][2][3][4][5][6][7].…”

“…However, a higher incidence of subsequent malignant disease may occur after renal transplantation [1][2][3][4][5][6][7].…”

Human papillomavirus is detected in transitional cell carcinoma arising in renal transplant recipients

“…The exact aetiology of TCC is not well established but there are several risk factors implicated in its pathogenesis such as cigarette smoking occupational carcinogens and analgesic abuse (2). The incidence of transitional cell carcinoma (TCC) in renal transplant recipients has been reported to be higher than the general population (3). However, the explanation of such observation is not clear.…”

Higher risk of urothelial carcinoma in the upper urinary tract than in the urinary bladder in hemodialysis patients

“…17 In addition, the time to the development of UTUC compared to renal cell carcinoma in dialysis patients has been reported to be much shorter in Taiwan than in Japan (54 vs. 143 months). 18 Of the 67 cases of UC in the patients undergoing HD in this study, 37 (55.2%) were diagnosed in the renal pelvis or ureters, and 30 (44.8%) in the bladder. This suggests that HD may be a risk factor for UTUC and is similar to the study by Chang et al, in which 54% of cases of UC involved the upper urinary tract in HD patients.…”