Risk Factors for De Novo Malignancies in Women After Kidney Transplantation A Multicenter Transversal Study

被引:3
作者
Helmy, Samir [1 ]
Marschalek, Julian [1 ]
Bader, Yvonne [2 ]
Koch, Marianne [1 ,3 ]
Schmidt, Alice [4 ]
Kanzler, Marina [5 ]
Gyoeri, Georg [6 ]
Polterauer, Stephan [1 ]
Reinthaller, Alexander [1 ,3 ]
Grimm, Christoph [1 ]
机构
[1] Med Univ Vienna, Ctr Comprehens Canc, Dept Gynecol & Gynecol Oncol, Gynecol Canc Unit, Waehringer Guertel 18-20, A-1090 Vienna, Austria
[2] Univ Clin Saarland, Dept Gynecol Obstet & Reprod Med, Saarland, Germany
[3] Karl Landsteiner Inst Gen Gynecol & Expt Gynecol, Vienna, Austria
[4] Med Univ Vienna, Dept Med 2, Div Nephrol & Dialysis, Vienna, Austria
[5] Hosp Rudolfstiftung, Div Nephrol & Dialysis, Dept Med 3, Vienna, Austria
[6] Med Univ Vienna, Dept Surg, Div Transplantat, Vienna, Austria
关键词
Renal disease; Kidney transplantation; Kidney graft; Malignancy; Cancer; RENAL-TRANSPLANTATION; CANCER INCIDENCE; RECIPIENTS; IMMUNOSUPPRESSION; COHORT;
D O I
10.1097/IGC.0000000000000710
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: Transplantation results in a 5-time elevated risk for a variety of malignancies (Kaposi sarcoma, skin, liver, lung, gastrointestinal cancer). A patient's risk for malignancies could be of particular interest for the follow-up programs of patients and risk adaption after kidney transplantation. The aim of this study was to identify independent risk factors for de novo malignancies in women after renal transplantation. Methods and Materials: This is a multicenter transversal study, conducted at the Medical University of Vienna and Hospital Rudolfstiftung, Vienna, Austria. We included female kidney graft recipients who were transplanted between 1980 and 2012 and followed-up at our institutions (N = 280). Clinical data of patients were extracted from hospital charts and electronic patient files. Patients were interviewed using a standardized questionnaire regarding their medical history, history of transplantation, and malignant diseases. Detailed information about present and past immunosuppressive regimens, rejection episodes and therapies, renal graft function, and information about primary disease was obtained. Diagnostic work-up and/or surgical exploration was performed if any presence of malignancy was suspected during routine follow-up. Histological specimens were obtained from all patients. Main outcome measures: the presence of de novo malignancy after kidney transplantation. Results: Two hundred sixty-two women were included for statistical analysis. Median (interquartile range) follow-up period after transplantation was 101.1 (27.3-190.7) months. Thirty-two patients (12.2%) developed a malignancy: dermatologic malignancies (5.7%), breast cancer (3.4%), cervical cancer (0.8%), lung cancer (0.4%), gastrointestinal malignancies (1.5%), vulvar cancer (0.4%), and unclassified malignancies (1.9%). Median (interquartile range) time to malignancy after transplantation was 185.9 (92.0-257.6) months. Cumulative cancer rates were 4.9% (1 year), 14.4% (3 years), 16.4% (5 years), and 21.8% (10 years). Second transplantations were identified as independent risk factor for development of malignancy after transplantation. Conclusions: Long-term risk of developing a malignancy after kidney transplantation is high, which might justify a follow-up of more than 10 years.
引用
收藏
页码:967 / 970
页数:4
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