Malignancy after renal transplantation: a single-centre experience

Vieira, P.; Bareto, P.; Pedroso, S.; Almeida, M.; Martins, L.; Dias, L.; Castro-Henriques, A.; Cabrita, A.

http://hdl.handle.net/10400.16/2243

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Introduction: Malignancy management in renal transplant recipients is becoming a major factor affecting long‑term patient survival. Thus, we intended to evaluate both incidence and prognosis of malignant diseases following renal transplantation at a single centre in Portugal. Methods: We studied retrospectively the 2,358 patients who underwent kidney transplantation (KT) between 1983 and 2014. Apart from descriptive analysis, both demographic and clinical characteristics of cancer and non‑cancer cancer patients were compared. Results: During a median follow‑up of 118 (IQR 57‑179) months, 139 patients (5.8%) developed 158 de novo malignancies, with a median time from KT to diagnosis of 76..5 (IQR 21.0‑132.0) months. When compared to non‑cancer patients, they were older at KT date, had longer graft survival and a lower living donor recipients’ prevalence. As for post-transplant malignancies analysis, the most common were non‑cutaneous non‑lymphomatous cancers (49.4%, n=78), skin cancers (35.4%, n=56) and post‑transplant lymphoproliferative disorders (9.5%, n=15). Considering specific diagnosis, squamous cell carcinoma and basal cell carcinoma with 17.1% and 16.5% respectively, and non‑Hodgkin lymphomas with 7.6%, were the most frequent. Global mortality among cancer patients was 36.0%, with a median time of 9.7 (IQR 1.9‑17.5) months from time of diagnosis to death. As for survival analysis, cancer patient survival was significantly lower while censored graft survival was significantly higher in this group. Conclusion: Incidence and characteristics of malignancy following renal transplantation in our unit are similar to those globally described, despite some traits probably a result of specific ethnic and environmental characteristics.