Master Viraj A, Meng Maxwell V, Grossfeld Gary D, Koppie Theresa M, Hirose Ryutaro, Carroll Peter R
Departments of Urology and Surgery, University of California, San Francisco, California 94143, USA.
J Urol. 2004 Mar;171(3):1085-8. doi: 10.1097/01.ju.0000110612.42382.0a.
Optimal management and clinical outcome of bladder cancer in renal transplant recipients are not well-defined. We analyzed single institution treatment strategies and outcomes of these patients.
We retrospectively reviewed the University of California, San Francisco transplant database which contains information on 6,288 renal transplants performed between 1964 and 2002. The United Network for Organ Sharing database and Israel Penn International Transplant Tumor Registry were also queried to characterize the global nature of bladder cancer in renal transplant recipients.
The United Network for Organ Sharing database (1986 to 2001) contained information on 31 patients who were found to have bladder cancer (0.024% prevalence) and the Israel Penn International Transplant Tumor Registry (1967 to 2001) contained information on 135 patients representing 0.84% of all reported malignancies. We identified 7 renal transplant recipients with bladder cancer at our institution. Invasive transitional cell carcinoma developed in 5 patients at a median of 2.8 years after transplant. Three patients underwent uncomplicated radical cystectomy and preservation of the renal allograft. Overall survival at 48 months was 60%.
Bladder cancer after renal transplantation is not common. For patients who present with invasive disease, traditional extirpative surgery should be considered. Moreover, the allograft is rarely the source of transitional cell carcinoma and can be preserved. In our experience the cancer and urinary outcomes compare favorably with nontransplant patient outcomes after treatment.
肾移植受者膀胱癌的最佳管理和临床结局尚未明确界定。我们分析了这些患者在单一机构的治疗策略和结局。
我们回顾性分析了加利福尼亚大学旧金山分校的移植数据库，该数据库包含1964年至2002年间进行的6288例肾移植的信息。还查询了器官共享联合网络数据库和以色列宾夕法尼亚国际移植肿瘤登记处，以描述肾移植受者膀胱癌的全球情况。
器官共享联合网络数据库（1986年至2001年）包含31例被发现患有膀胱癌患者的信息（患病率为0.024%），以色列宾夕法尼亚国际移植肿瘤登记处（1967年至2001年）包含135例患者的信息，占所有报告恶性肿瘤的0.84%。我们在本机构识别出7例患有膀胱癌的肾移植受者。5例患者在移植后中位2.8年发生浸润性移行细胞癌。3例患者接受了无并发症的根治性膀胱切除术并保留了同种异体肾。48个月时的总生存率为60%。
肾移植后膀胱癌并不常见。对于出现浸润性疾病的患者，应考虑传统的根治性手术。此外，同种异体肾很少是移行细胞癌的来源，可以保留。根据我们的经验，治疗后癌症和泌尿系统结局与非移植患者的结局相比良好。
