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[Neoplasm prevalence in renal transplantation]
V Gómez dos Santos1, F J Burgos Revilla, J Pascual Santos
1Servicio de Urología y Nefrología, Hospital Ramón y Cajal, Departamento de Ciencias Morfológicas y Cirugía, Universidad de Alcalá, Madrid, España.
Objective:
To analyze the prevalence of neoplasms in renal transplant patients and the relative risk for each tumor type according to the immunosuppression regimen.
Methods:
609 renal transplants were reviewed. The risk index was determined by the ratio of the cases observed and predicted.
Results:
Tumor prevalence was 4.9% (30/609); 6.3% (25/393) were males and 2.3% (5/216) were females. The most common tumors were cutaneous tumors other than melanoma, accounting for 2.4% (15/609), followed by Kaposi's sarcoma, pulmonary epidermoid carcinoma and genitourinary tumors (0.5%) and non-Hodgkin lymphoma (0.3%). Tumor prevalence was 6.8% for the group treated with azathioprine-prednisone and 3.9% for the cyclosporine A-prednisone-treated group. The estimated relative risk of having a neoplasm was 10-fold higher for the males and 4.2-fold higher for the females vs the general population. The mortality rate was 36.6%; specifically tumor-related in 82%. The mortality rate for those with solid tumors was 77.7%. The long-term survival rate for the group that developed a tumor was significantly lower than that of the general population, 75% vs 53%, respectively (p < 0.05).
Conclusion:
In this series no significant differences were observed relative to tumor prevalence or type according to the immunosuppression regimen. A recipient of a renal graft has a higher risk of developing a tumor. Cutaneous tumors were the most frequent. The long-term survival is lower for recipients of renal grafts who develop a tumor.