Autor(es): Vieira,Pedro ; Barreto,Patrícia ; Pedroso,Sofia ; Almeida,Manuela ; Martins,La Salete ; Dias,Leonídio ; Henriques,António Castro ; Cabrita,António
Data: 2016
Origem: SciELO Portugal
Assunto(s): epidemiology; kidney transplantation; neoplasms
Introduction: Malignancy management in renal transplant recipients is becoming a major factor affecting long-term patient survival. Thus, we intended to evaluate both incidence and prognosis of malignant diseases following renal transplantation at a single centre in Portugal. Methods: We studied retrospectively the 2,358 patients who underwent kidney transplantation (KT) between 1983 and 2014. Apart from descriptive analysis, both demographic and clinical characteristics of cancer and non-cancer cancer patients were compared. Results: During a median follow-up of 118 (IQR 57-179) months, 139 patients (5.8%) developed 158 de novo malignancies, with a median time from KT to diagnosis of 76..5 (IQR 21.0-132.0) months. When compared to non-cancer patients, they were older at KT date, had longer graft survival and a lower living donor recipients prevalence. As for post-transplant malignancies analysis, the most common were non-cutaneous non-lymphomatous cancers (49.4%, n=78), skin cancers (35.4%, n=56) and post-transplant lymphoproliferative disorders (9.5%, n=15). Considering specific diagnosis, squamous cell carcinoma and basal cell carcinoma with 17.1% and 16.5% respectively, and non-Hodgkin lymphomas with 7.6%, were the most frequent. Global mortality among cancer patients was 36.0%, with a median time of 9.7 (IQR 1.9-17.5) months from time of diagnosis to death. As for survival analysis, cancer patient survival was significantly lower while censored graft survival was significantly higher in this group. Conclusion: Incidence and characteristics of malignancy following renal transplantation in our unit are similar to those globally described, despite some traits probably a result of specific ethnic and environmental characteristics
