De novo upper tract urothelial carcinoma after renal transplantation: a single-center experience in China

被引:2
作者
Li, Shixin [1 ,2 ,3 ]
Zhang, Jian [1 ,2 ]
Tian, Ye [1 ]
Zhu, Yichen [1 ]
Guo, Yuwen [1 ]
Wang, Zhipeng [1 ]
Yang, Yang [1 ]
Ding, Guangpu [1 ]
Lin, Jun [1 ,2 ]
机构
[1] Capital Med Univ, Beijing Friendship Hosp, 95 Yongan Rd, Beijing, Peoples R China
[2] Beijing Key Lab Tolerance Induct & Organ Protect T, 95 Yongan Rd, Beijing, Peoples R China
[3] Qilu Hosp Shandong Univ Dezhou Hosp, Dezhou, Peoples R China
关键词
Renal transplantation; Upper tract urothelial carcinoma; Aristolochic acid; Prognosis; Prophylactic contralateral resection; TRANSITIONAL-CELL CARCINOMA; UPPER URINARY-TRACT; ARISTOLOCHIC ACID EXPOSURE; KIDNEY-TRANSPLANTATION; RADICAL NEPHROURETERECTOMY; LIVER-TRANSPLANT; RISK-FACTORS; CANCER; RECIPIENTS; NATIONWIDE;
D O I
10.1186/s12894-023-01190-0
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
BackgroundLong-term prognosis and risk factors of de novo upper tract urothelial carcinoma after renal transplantation were rarely studied. Thus, the aim of this study was to investigate the clinical features, risk factors, and long-term prognosis of de novo upper tract urothelial carcinoma after renal transplantation, especially the impact of aristolochic acid on tumor, using a large sample.Methods106 patients were enrolled in retrospective study. The endpoints included overall survival, cancer-specific survival, bladder or contralateral upper tract recurrence-free survival. Patients were grouped according to aristolochic acid exposure. Survival analysis was performed using Kaplan-Meier curve. Log-rank test was used to compare the difference. Multivariable cox regression was conducted to evaluate the prognostic significance.ResultsMedian time from transplantation to development of upper tract urothelial carcinoma was 91.5 months. Cancer-specific survival rate at 1, 5, 10 years was 89.2%, 73.2%, 61.6%. Tumor staging (>= T2), lymph node status (N +) were independent risk factors for cancer-specific death. Contralateral upper tract recurrence-free survival rate at 1, 3, 5 years was 80.4%, 68.5%, 50.9%. Aristolochic acid exposure was independent risk factor for contralateral upper tract recurrence. The patients exposed to aristolochic acid had more multifocal tumors and higher incidence of contralateral upper tract recurrence.ConclusionBoth higher tumor staging and positive lymph node status were associated with a worse cancer-specific survival in patients with post-transplant de novo upper tract urothelial carcinoma, which highlighted the importance of early diagnosis. Aristolochic acid was associated with multifocality of tumors and higher incidence of contralateral upper tract recurrence. Thus, prophylactic contralateral resection was suggested for post-transplant upper tract urothelial carcinoma, especially for patients with aristolochic acid exposure.
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页数:12
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共 33 条
  • [1] Urothelial Cancer in Renal Transplant Recipients: Incidence, Risk Factors, and Oncological Outcome
    Ardelt, Peter U.
    Rieken, Malte
    Ebbing, Jan
    Bonkat, Gernot
    Vlajnic, Tatjana
    Bubendorf, Lukas
    Grobholz, Rainer
    Steiger, Juerg
    Bachmann, Alexander
    Burkhalter, Felix
    [J]. UROLOGY, 2016, 88 : 104 - 109
  • [2] Cancer in kidney transplant recipients
    Au, Eric
    Wong, Germaine
    Chapman, Jeremy R.
    [J]. NATURE REVIEWS NEPHROLOGY, 2018, 14 (08) : 508 - 520
  • [3] Urothelial Cancer After Renal Transplantation: An Update
    Chiang, Y. -J.
    Yang, P. -S.
    Wang, H. -H.
    Lin, K. -J.
    Liu, K. -L.
    Chu, S. -H.
    Hsieh, C. -Y.
    [J]. TRANSPLANTATION PROCEEDINGS, 2012, 44 (03) : 744 - 745
  • [4] Upper urinary tract urothelial carcinoma behaviors in patients with end-stage renal disease after kidney transplantation in Taiwan
    Chien, Chia-Shen
    Luo, Hao Lun
    Ling, Chou Shu
    Chiang, Po-Hui
    Chen, Yen-Ta
    Cheng, Yuan Tso
    [J]. INTERNATIONAL UROLOGY AND NEPHROLOGY, 2016, 48 (08) : 1261 - 1265
  • [5] Survival and risk factors among upper tract urothelial carcinoma patients after radical nephroureterectomy in Northeast China
    Gao, Jianing
    Liu, Jingya
    Liu, Jianyu
    Lin, Shiyan
    Ding, Dexin
    [J]. FRONTIERS IN ONCOLOGY, 2022, 12
  • [6] Native Kidney Hydronephrosis Is Associated with Upper Urinary Tract Urothelial Carcinoma in Post-Kidney Transplantation Patients
    Ho, Cheng-Ju
    Huang, Yu-Hui
    Hsieh, Tzuo-Yi
    Yang, Min-Hsin
    Wang, Shao-Chuan
    Chen, Wen-Jung
    Lee, Tsung-Hsien
    Sung, Wen-Wei
    Chen, Sung-Lang
    [J]. JOURNAL OF CLINICAL MEDICINE, 2021, 10 (19)
  • [7] Cyclosporine induces cancer progression by a cell-autonomous mechanism
    Hojo, M
    Morimoto, T
    Maluccio, M
    Asano, T
    Morimoto, K
    Lagman, M
    Shimbo, T
    Suthanthiran, M
    [J]. NATURE, 1999, 397 (6719) : 530 - 534
  • [8] Contralateral Nephroureterectomy for Renal Transplant Recipients With Unilateral Upper Urinary Tract Transitional Cell Carcinoma: A Report of 12 Cases
    Hou, H. J.
    Xiao, J.
    Tian, Y.
    [J]. TRANSPLANTATION PROCEEDINGS, 2013, 45 (06) : 2203 - 2206
  • [9] Primary Urothelial Carcinoma of the Upper Urinary Tract in Dialysis Patients with 5-year Follow-up
    Kang, Chih-Hsiung
    Chen, Chien-Hsu
    Chiang, Po-Hui
    [J]. JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 40 (03) : 241 - 246
  • [10] Cancer and mTOR inhibitors in kidney transplantation recipients
    Kao, Chih-Chin
    Liu, Jia-Sin
    Chang, Yu-Kang
    Lin, Ming-Huang
    Lin, Yen-Chung
    Chen, Hsi-Hsien
    Chang, Wei-Chiao
    Hsu, Chih-Cheng
    Wu, Mai-Szu
    [J]. PEERJ, 2018, 6