PATHOLOGY & ONCOLOGY RESEARCHVol. 13 No. 1, 2007

 Article

Malignancies after Renal Transplantation during 33 Years at a Single Center

Gyula VÉGSŐ1, Mária TÓTH2, Márta HÍDVÉGI1, Éva TORONYI1, Robert M LANGER1, Elek DINYA2, András TÓTH1, Ferenc PERNER1, Jenő JÁRAY1

1Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
2Medical Division, EGIS Pharmaceutical PLC, Budapest, Hungary

 

This study provides an analysis of incidence and characteristics of malignant tumors of 2535 patients who underwent renal transplantation between 1973 and 2007 at the Transplantation Center in Budapest. One hundred ninety-three malignant diseases were found in 188 patients (7.6%). The incidence of thyroid-, renal- hepatic-, skin- and gastric cancers as well as of Kaposi sarcoma and lymphomas increased in our transplant patient cohort compared to the figures of the general population based on the data of our Cancer Registry. On the other hand, colorectal-, oralprostate and lung cancers were underrepresented in our patient cohort. The mean time of diagnosis of malignancies following kidney transplantation was 58.5±44.8 months. One fifth of the tumors were detected within the first year. Patients with malignancies were distributed into four groups based on the immunosuppressive regimen: group I (8.5%), azathioprine + prednisone; group II (59.0%), cyclosporine + prednisone; group III (26.6%), cyclosporine + mycophenolate mofetil + prednisone; group IV (5.9%), tacrolimus + mycophenolate mofetil + prednisone. The mean age of patients was 47.3, 53.5, 55.5 and 58.1 years in group I, II, III and IV, respectively. Oncologic and immunosuppressive therapy was decided individually. Immunosuppression was switched to rapamycin-containing regimens in 63 cases. We lost 92 patients (48.9%) with a mean survival time of 25.8±39.4 months. Cumulative 1- and 5-year survivals were 69.5% and 52%, respectively. The increasing number of cancers seen early after transplantation and the increased risk of developing a cancer due to the older age of recipients draw attention to the importance of regular oncologic screening in patients on the waiting list and after transplantation. Pathology & Oncology Research, Vol 13, Nr 1, 63-69, 2007

Key words: immunosuppression; kidney transplantation; posttransplant malignancies; tumor risk; waiting list


Received: Jan 22, 2007; accepted: Feb 16, 2007
Correspondence: Gyula VÉGSŐ, Department of Transplantation and Surgery, Semmelweis University, Baross u. 23 Budapest H-1082, Hungary; Tel: +36-1-267-6000, Fax: +36-1-317-0964; E-mail: vegso@trans.sote.hu

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