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Published on: April 12, 2017
Oncological Screening of Kidney Tumors After Renal Transplantation
Gergely Kiss1, Bálint Székely2, Ádám Zoltán Farkas1
1Medical Imaging Center, Semmelweis University, Budapest, Hungary.
Background:
Among renal transplant recipients, renal cell carcinoma in the native kidneys represents the most common solid tumor. At the Department of Surgery, Transplantation and Gastroenterology of Semmelweis University annual control abdominal ultrasound examination is recommended for transplant patients. Our goal was to evaluate the effectiveness of the ultrasound screening program at our institute and to learn about the characteristics of shrunken kidney tumors.
Methods:
Retrospectively, we processed the results of abdominal and pelvic ultrasound examinations of 1687 kidney transplant patients, which were performed at our institute between January 1, 2012 and December 31, 2016.
Results:
A total of 26 tumors were detected during the abovementioned period of time, of which 18 were renal cancers. Renal cancer was significantly (P = 0.029) more common in men. Seventeen renal cancers were classified as stage I and one as stage IV disease. The mean time of dialysis was 37.73 ± 24.37 months. The mean time between kidney transplantation and tumor recognition was 7.9 ± 6.29 years. The 5-year survival was 66%; however, it should be noted that only 1 patient lost his life due to his tumor disease. The mean time between the last 2 ultrasound examinations was 27.8 ± 23.89 months. Only 57% of tumors were detected by screening. No significant differences in tumor size, stage, and survival could be detected between screened and nonscreened renal cancer patients.
Conclusions:
Ultrasound examination at least every 2 years is an effective tool for the early detection of renal cell carcinoma of the shrunken kidneys.
Insights
Ultrasound screening detects renal cell carcinoma in kidney transplant patients, though only 57% of tumors were found this way. Regular ultrasounds are effective for early detection of these native kidney tumors.
Area of Science:
- Nephrology
- Oncology
- Radiology
Background:
- Renal cell carcinoma (RCC) is the most common solid tumor in native kidneys of transplant recipients.
- Annual abdominal ultrasound is recommended for transplant patients at Semmelweis University.
- This study evaluates the effectiveness of ultrasound screening for RCC in this population.
Purpose of the Study:
- To assess the efficacy of an ultrasound screening program for detecting renal cell carcinoma in kidney transplant recipients.
- To characterize shrunken kidney tumors found in native kidneys of transplant patients.
Main Methods:
- Retrospective analysis of abdominal and pelvic ultrasound examinations.
- Data from 1687 kidney transplant patients between January 1, 2012, and December 31, 2016.
- Evaluation of tumor characteristics, detection methods, and patient survival.
Main Results:
- 26 tumors detected, including 18 renal cancers (RCC).
- RCC was more common in men (P=0.029). Most cancers were Stage I.
- Screening detected only 57% of tumors; 5-year survival was 66% with low tumor-related mortality.
Conclusions:
- Periodic ultrasound screening (at least every 2 years) is effective for early detection of native kidney RCC in transplant recipients.
- While screening is valuable, a significant portion of tumors were detected outside of scheduled screenings.
- Further research may optimize screening protocols for this high-risk population.
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