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919 Cancer screening can improve overall and cancer-specific survival in kidney transplant recipients
919
Cancer screening can improve overall and cancer-specific survival in kidney transplant recipients Eur Urol Suppl 2014;13;e919
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Kakuta Y., Kato T., Yamanaka K., Masayoshi O., Nonomura N. Osaka University Graduate School Of Medicine, Dept. of Urology, Suita, Japan INTRODUCTION & OBJECTIVES: Kidney transplant recipients (KTRs) are at higher risk of cancer than general population. In addition, malignancy after kidney transplantation was one of the major causes of death with functioning grafts. Cancer screening, which detects early-stage cancer and allows curative treatment, is considered to be effective in reducing cancer-related mortality and morbidity in KTRs. We examined the incidence of malignancy, survival rate, and the efficacy of cancer screening in our institute. MATERIAL & METHODS: We investigated malignancies occurring in 732 KTRs receiving regular follow-up with and without cancer screening at Soryukai Inoue Hospital after kidney transplantation between 1993 and 2013 on the basis of medical records. As cancer screening, we performed annually tumour marker tests, urinalysis test, fecal occult blood test, ultrasound scan of thyroid and abdomen, CT scan of the chest, abdomen and pelvis, gastroscopy, mammography and Pap smear. RESULTS: We identified 77 malignancies including patients with multiple primary neoplasms, an overall incidence of 10.5 %. The mean follow-up time was 15.1 ± 8.2 yr. The mean time from transplantation to tumour detection was 11.0 ± 7.6 yr. The cumulative incidence of all cancers was 2.1% at 5 years, 6.5% at 10 years, 12.3% at 20 years, and 17.2% at 25 years. Post transplant lymphoproliferative disorder represented the most frequent malignancies (19.5 %), followed by renal cell carcinoma (13.0 %), breast cancer (11.7 %), gastric cancer (10.4 %), thyroid cancer (6.5 %) and colon cancer (6.5%). When we investigated overall survival and cancer-specific survival, we observed a significantly improved both survival for the KTRs received cancer screening compared with KTRs received no cancer screening (Fig.1(p<0.01), Fig.2 (p<0.05), respectively). CONCLUSIONS: The incidence of cancer in recipients after kidney transplantation increased in a time dependent manner and reached to 12.8% at 20 years. Consequently, with long-term renal graft survival now feasible, attention must be paid to detecting malignancy after transplantation. Cancer screening might be effective in reducing cancer-related mortality in our series.
Cancer screening can improve overall and cancer-specific survival in kidney transplant recipients Eur Urol Suppl 2014;13;e919
Print! Print!
Kakuta Y., Kato T., Yamanaka K., Masayoshi O., Nonomura N. Osaka University Graduate School Of Medicine, Dept. of Urology, Suita, Japan INTRODUCTION & OBJECTIVES: Kidney transplant recipients (KTRs) are at higher risk of cancer than general population. In addition, malignancy after kidney transplantation was one of the major causes of death with functioning grafts. Cancer screening, which detects early-stage cancer and allows curative treatment, is considered to be effective in reducing cancer-related mortality and morbidity in KTRs. We examined the incidence of malignancy, survival rate, and the efficacy of cancer screening in our institute. MATERIAL & METHODS: We investigated malignancies occurring in 732 KTRs receiving regular follow-up with and without cancer screening at Soryukai Inoue Hospital after kidney transplantation between 1993 and 2013 on the basis of medical records. As cancer screening, we performed annually tumour marker tests, urinalysis test, fecal occult blood test, ultrasound scan of thyroid and abdomen, CT scan of the chest, abdomen and pelvis, gastroscopy, mammography and Pap smear. RESULTS: We identified 77 malignancies including patients with multiple primary neoplasms, an overall incidence of 10.5 %. The mean follow-up time was 15.1 ± 8.2 yr. The mean time from transplantation to tumour detection was 11.0 ± 7.6 yr. The cumulative incidence of all cancers was 2.1% at 5 years, 6.5% at 10 years, 12.3% at 20 years, and 17.2% at 25 years. Post transplant lymphoproliferative disorder represented the most frequent malignancies (19.5 %), followed by renal cell carcinoma (13.0 %), breast cancer (11.7 %), gastric cancer (10.4 %), thyroid cancer (6.5 %) and colon cancer (6.5%). When we investigated overall survival and cancer-specific survival, we observed a significantly improved both survival for the KTRs received cancer screening compared with KTRs received no cancer screening (Fig.1(p<0.01), Fig.2 (p<0.05), respectively). CONCLUSIONS: The incidence of cancer in recipients after kidney transplantation increased in a time dependent manner and reached to 12.8% at 20 years. Consequently, with long-term renal graft survival now feasible, attention must be paid to detecting malignancy after transplantation. Cancer screening might be effective in reducing cancer-related mortality in our series.