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Recurrence of renal cell cancer after renal transplantation in a multicenter French cohort

Cognard Noëlle MD; Anglicheau, Dany MD, PhD; Gatault, Philippe MD, PhD; Girerd, Sophie MD, MSc; Essig, Marie MD, PhD; Hurault de Ligny, Bruno MD, PhD; Le Meur, Yann MD, PhD; Le Roy, Franck MD; Garrouste, Cyril MD; Thierry, Antoine MD, PhD; Colosio, Charlotte MD; Rivalan, Joseph MD; Sayegh, Johnny MD; Choukroun, Gabriel MD, PhD; Moulin, Bruno MD PhD; Caillard, Sophie MD, PhD
doi: 10.1097/TP.0000000000002009
Original Clinical Science—General: PDF Only

ABSTRACT

Background

Renal cancer accounts for 3% of adult malignancies; renal cell carcinoma (RCC) represents 80% of all renal cancers, and is characterized by late recurrences. Recurrences after kidney transplantation are associated with a high mortality rate. We aimed to determine if recurrences are linked to tumor characteristics and to delays between diagnosis and transplantation.

Methods

We retrospectively analyzed data from French kidney-transplanted patients with medical histories of pre-transplant renal cancer, focusing on the most common histological subtypes: clear cell and papillary cancers. Characteristics of the tumors, patients, and kidney transplantations were documented, and posttransplant patient survival was analyzed.

Results

Of 143 patients, 13 experienced cancer recurrence after kidney transplantation. The mean delay in recurrence was 3±2.3 years posttransplantation, and the cumulative incidences of recurrence were 7.7% at 5 years and 14.9% at 10 years. The risk of recurrence was higher in patients with clear cell RCC (13% vs. 0%, p=0.015). There was no correlation between posttransplant recurrence and the interval before transplantation. Factors associated with a higher risk of cancer recurrence were histological clear cell RCC (p=0.025), tumor stage pT2 (p=0.002) and Fuhrman grade IV (p<0.001). Recurrences were associated with a high mortality rate; 76.9% of patients with recurrences had died by the end of the follow-up period.

Conclusions

Recurrences of clear cell RCC are not uncommon after kidney transplantation, and are associated with very poor prognoses. These results should be considered before listing patients with a history of renal cancer for transplantation.

Correspondence information: Noëlle COGNARD, University Hospital, Nephrology-Transplantation Department, Nouvel Hôpital Civil, 1, Place de l’Hôpital, 67000 Strasbourg, France, Noelle.cognard@chru-strasbourg.fr

Authorship information

Noelle Cognard collected the data, performed research, analyzed data, and contributed to the writing and revision of the paper.

Dany Anglicheau collected data and contributed to the revision of the paper.

Philippe Gatault collected data and contributed to the revision of the paper.

Sophie Girerd collected data and contributed to the revision of the paper.

Marie Essig collected data and contributed to the revision of the paper.

Bruno Hurault de Ligny collected data and contributed to the revision of the paper.

Yann Le Meur collected data and contributed to the revision of the paper.

Franck Le Roy collected data and contributed to the revision of the paper.

Cyril Garrouste collected data and contributed to the revision of the paper.

Antoine Thierry collected data and contributed to the revision of the paper.

Charlotte Colosio collected data and contributed to the revision of the paper.

Joseph Rivalan collected data and contributed to the revision of the paper.

Johnny Sayegh collected data and contributed to the revision of the paper.

Gabriel Choukroun collected data and contributed to the revision of the paper.

Bruno Moulin contributed to the designing of the study and revision of the paper.

Sophie Caillard designed the study, performed research, collected data, analyzed data, and contributed to the writing and revision of the paper.

All authors approved the final version of the manuscript.

The authors declare no conflicts of interest.

Funding: This study was not funded by any external source.

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