De-novo malignancies after kidney transplantation: A long-term observational study.
Adult
Aged
Carcinoma, Renal Cell
/ diagnosis
Female
Humans
Immunosuppressive Agents
/ adverse effects
Kidney Transplantation
/ adverse effects
Liver Transplantation
/ adverse effects
Longitudinal Studies
Lymphoproliferative Disorders
/ diagnosis
Male
Middle Aged
Neoplasms
/ diagnosis
Retrospective Studies
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
25
05
2020
accepted:
10
11
2020
entrez:
30
11
2020
pubmed:
1
12
2020
medline:
8
1
2021
Statut:
epublish
Résumé
De-novo malignancies after kidney transplantation represent one major cause for mortality after transplantation. However, most of the studies are limited due to small sample size, short follow-up or lack of information about cancer specific mortality. This long-term retrospective analysis included all adult patients with complete follow-up that underwent kidney transplantation between 1995 and 2016 at our centre. All patients with diagnosis of malignancy excluding non-melanoma skin cancer (NMSC) were identified and a matched control group was assigned to the kidney transplant recipients with post-transplant malignancies. 1417 patients matched the inclusion criteria. 179 malignancies posttransplant were diagnosed in 154 patients (n = 21 with two, n = 2 patients with three different malignancies). Mean age at cancer diagnosis was 60.3±13.3 years. Overall incidence of de-novo malignancies except NMSC was 1% per year posttransplant. Renal cell carcinoma was the most common entity (n = 49, incidence 4.20 per 1000 patient years; cancer specific mortality 12%), followed by cancer of the gastro-intestinal tract (n = 30, 2.57; 50%), urinary system (n = 24, 2.06; 13%), respiratory system (n = 18, 1.54; 89%), female reproductive system (n = 15, 1.29; 13%), posttransplant lymphoproliferative disorders and haematological tumours (n = 14, 1.20; 21%), cancers of unknown primary (n = 7, 0.60 100%) and others (n = 22, 1.89; 27%). Male sex, re-transplantation and time on dialysis were associated with de-novo malignancies after transplantation. De-novo malignancies continue to be a serious problem after kidney transplantation. To improve long-term outcome after Kidney transplantation, prevention and cancer screening should be more tailored and intensified.
Sections du résumé
BACKGROUND
De-novo malignancies after kidney transplantation represent one major cause for mortality after transplantation. However, most of the studies are limited due to small sample size, short follow-up or lack of information about cancer specific mortality.
METHODS
This long-term retrospective analysis included all adult patients with complete follow-up that underwent kidney transplantation between 1995 and 2016 at our centre. All patients with diagnosis of malignancy excluding non-melanoma skin cancer (NMSC) were identified and a matched control group was assigned to the kidney transplant recipients with post-transplant malignancies.
RESULTS
1417 patients matched the inclusion criteria. 179 malignancies posttransplant were diagnosed in 154 patients (n = 21 with two, n = 2 patients with three different malignancies). Mean age at cancer diagnosis was 60.3±13.3 years. Overall incidence of de-novo malignancies except NMSC was 1% per year posttransplant. Renal cell carcinoma was the most common entity (n = 49, incidence 4.20 per 1000 patient years; cancer specific mortality 12%), followed by cancer of the gastro-intestinal tract (n = 30, 2.57; 50%), urinary system (n = 24, 2.06; 13%), respiratory system (n = 18, 1.54; 89%), female reproductive system (n = 15, 1.29; 13%), posttransplant lymphoproliferative disorders and haematological tumours (n = 14, 1.20; 21%), cancers of unknown primary (n = 7, 0.60 100%) and others (n = 22, 1.89; 27%). Male sex, re-transplantation and time on dialysis were associated with de-novo malignancies after transplantation.
CONCLUSION
De-novo malignancies continue to be a serious problem after kidney transplantation. To improve long-term outcome after Kidney transplantation, prevention and cancer screening should be more tailored and intensified.
Identifiants
pubmed: 33253202
doi: 10.1371/journal.pone.0242805
pii: PONE-D-20-14163
pmc: PMC7703884
doi:
Substances chimiques
Immunosuppressive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0242805Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Am J Transplant. 2017 Jan;17(1):103-114
pubmed: 27575845
Korean J Pediatr. 2017 Mar;60(3):86-93
pubmed: 28392824
Am J Transplant. 2004 Jun;4(6):905-13
pubmed: 15147424
Int J Cancer. 2009 Oct 15;125(8):1747-54
pubmed: 19444916
Int J Cancer. 2020 Feb 1;146(3):682-691
pubmed: 30919451
J Oncol. 2019 Feb 28;2019:5796108
pubmed: 30941176
Transplant Proc. 2015 Sep;47(7):2198-200
pubmed: 26361679
Cancer Epidemiol. 2011 Apr;35(2):105-11
pubmed: 20674538
Acta Oncol. 2019 Jun;58(6):859-863
pubmed: 30821595
Transplantation. 2012 Nov 27;94(10):990-8
pubmed: 23085553
Transplant Proc. 2019 Jan - Feb;51(1):120-123
pubmed: 30655157
Clin Transpl. 1998;:147-58
pubmed: 10503093
Eur Urol. 2011 Aug;60(2):366-73
pubmed: 21377780
Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1251-65
pubmed: 25209964
Am J Transplant. 2007 Sep;7(9):2140-51
pubmed: 17640312
Oncotarget. 2019 May 3;10(33):3114-3128
pubmed: 31139324
J Am Soc Nephrol. 2019 Feb 14;:
pubmed: 30765426
JAMA Surg. 2015 Mar 1;150(3):252-9
pubmed: 25629390
Am J Transplant. 2018 Jul;18(7):1810-1814
pubmed: 29633548
Transplant Proc. 2015 Nov;47(9):2618-21
pubmed: 26680052
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Jun 20;37(6):715-720
pubmed: 28669942
Cancer. 2019 Aug 1;125(15):2647-2655
pubmed: 31034602
Transplant Proc. 2018 Jun;50(5):1348-1354
pubmed: 29753463
Kidney Int. 2007 Jun;71(12):1271-8
pubmed: 17332737
Cancer Nurs. 2019 Jan/Feb;42(1):E28-E35
pubmed: 29334522
Transplant Proc. 2013 Apr;45(3):1102-5
pubmed: 23622637
N Engl J Med. 2020 Feb 6;382(6):503-513
pubmed: 31995683
Am J Transplant. 2009 Aug;9(8):1868-75
pubmed: 19563337
Nephrol Dial Transplant. 2019 Dec 1;34(12):2132-2143
pubmed: 31168571
Cancer. 2005 Nov 1;104(9):1962-7
pubmed: 16187269
Nephrol Dial Transplant. 2006 Aug;21(8):2256-62
pubmed: 16574677
Curr Oncol. 2016 Jun;23(3):e179-87
pubmed: 27330355
Eur J Cancer. 2013 Jan;49(2):336-44
pubmed: 23062667
J Nephrol. 2015 Dec;28(6):659-68
pubmed: 26202137
J Am Soc Nephrol. 2000 Oct;11 Suppl 15:S1-86
pubmed: 11044969
Transpl Int. 2000;13 Suppl 1:S394-8
pubmed: 11112040
Transplant Rev (Orlando). 2014 Apr;28(2):76-83
pubmed: 24439783
Cancer Sci. 2010 Nov;101(11):2430-5
pubmed: 20707803
Am J Transplant. 2006 Nov;6(11):2735-42
pubmed: 17049061
Blood. 2011 May 12;117(19):5019-32
pubmed: 21300984
JAMA Oncol. 2016 Apr;2(4):463-9
pubmed: 26746479
Transplant Rev (Orlando). 2010 Oct;24(4):172-89
pubmed: 20709518
Swiss Med Wkly. 2019 May 19;149:w20078
pubmed: 31104307
JAMA. 2011 Nov 2;306(17):1891-901
pubmed: 22045767
Lancet. 1999 Jul 10;354(9173):93-9
pubmed: 10408483
Transplant Rev (Orlando). 2012 Oct;26(4):261-79
pubmed: 22902168
Transplantation. 2009 May 15;87(9):1347-59
pubmed: 19424035
Cold Spring Harb Perspect Med. 2013 Jul 01;3(7):
pubmed: 23818517
Transpl Int. 2014 Jul;27(7):721-32
pubmed: 24684689
Transplant Proc. 2015 May;47(4):976-80
pubmed: 26036498
Transpl Int. 2015 Jun;28(6):710-9
pubmed: 25639331