Department of Urology and Pediatric Urology, University Medical Center Frankfurt, Frankfurt, Germany.
Department of Nephrology, University Medical Center Frankfurt, Frankfurt, Germany; KFH Kidney Center Frankfurt (Outpatient Clinic), Frankfurt, Germany; Molecular Immunooncology, Department of Surgery, University Medical Center Würzburg, Würzburg, Germany; and Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
The aim of the current study was to explore the clinico-oncological characteristics, and the therapeutic and survival parameters, of renal transplant recipients who developed de novo transitional cell carcinoma (TCC) over a 30-year period at the authors' center.
Retrospective analysis of records from all registered patients who underwent kidney transplantation at the center between November 1979 and January 2010 who developed de novo TCC of the urinary tract.
From all 2001 patients analyzed during the study period, 21 recipients developed 19 TCCs of the bladder and 6 TCCs of the upper urinary tract. Among bladder TCCs, 13 (68.4%) cases were confined to mucosa (pTa or carcinoma in situ, n = 7) or submucosa (pT1, n = 6) and 6 others (31.6%) infiltrated the detrusor muscle (≥p T2); the grading distribution was 5 cases of G1, 6 of G2 and 8 of G3. All recurrent cases (n = 8) revealed local or systemic progression. The overall and tumor-specific patient survival rates were 80.2%, 54.0% and 30.0% and 84.9%, 67.4% and 58.9% for 1, 5 and 10 years, respectively.
In the light of the observed increased aggressiveness of TCC in renal transplant recipients, more frequent examinations and possibly more invasive follow-up protocols should be considered for patients with 1 or more risk factors for development of TCC. Urine cytology (including ureteral wash cytology) may be used as a reliable diagnostic tool in these patients. Prophylactic contralateral nephroureterectomy might be an option in patients at high risk.
Written by:
Tsaur I, Karalis A, Blaheta R, Juengel E, Vallo S, Scheuermann EH, Kachel HG, Waaga-Gasser AM, Chandraker A, Obermüller N, Probst M. Are you the author?
Reference: Am J Med Sci. 2011 Mar 15. Epub ahead of print.
PubMed Abstract
PMID: 21412138
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