Detection and management of renal cell carcinoma in the renal allograft

作者：Vegso Gyula^*; Toronyi Eva; Deak Pal Akos; Doros Attila; Langer Robert Miklos

来源：International Urology and Nephrology, 2013, 45(1): 93-98.

DOI：10.1007/s11255-012-0274-1

• Early tumour detection
• Nephron-sparing surgery
• Percutaneous ablative therapy
• Renal allograft tumour
• Renal cell carcinoma
• Renal transplantation

Tumours of the transplanted kidney represent a rare form of post-transplantation malignancies. An important aspect of the treatment option is whether the transplanted kidney can be saved or not. Aim of our study was the analysis of our allograft tumours. %26lt;br%26gt;In the Budapest Centre, 3,530 kidney transplantations were performed between 1973 and 2012. Retrospective analysis of 9 patients who developed renal cell carcinoma (RCC) in the transplanted kidney was done. %26lt;br%26gt;Mean age of recipients was 45.3 +/- A 13.4 years at the time of transplantation and 57.0 +/- A 11.6 years at the time of tumour detection. Mean age of their donors was 43.5 +/- A 11.5 years. Mean time from transplantation to tumour diagnosis was 134.6 +/- A 40.8 months. Seven RCC were stage pT1a, 1 was stage pT1b and 1 was pT3a. Eight patients had stage I. (pT1a-b, N0, M0) and 1 patient had stage IV. (pT3a, N1, M1) disease. Histological types were clear cell (n = 6), papillary (n = 2) and sarcomatoid (n = 1) carcinomas. The tumour growth rate of RCC was 16.7 +/- A 13.5 mm/year. In 4 cases, transplant nephrectomy was performed; 5 cases had percutaneous radiofrequency ablation (RFA). Ablative therapy had no influence on renal graft function. Six patients (including 5 patients who were treated with RFA) are still alive and tumour-free; 3 patients died. %26lt;br%26gt;According to our observation, we can state that RCC of the kidney allograft diagnosed at an early stage can be successfully treated with RFA instead of graft removal. A longer follow-up is needed to assess the effectivity of the RFA treatment in these cases.

• 出版日期2013-2