Filocamo M T, Zanazzi M, Li Marzi V, Guidoni L, Villari D, Dattolo E, Nicita G
Clinica Urologica II, University of Florence, Viale Pieraccini 18, 50139 Florence, Italy.
Transplant Proc. 2009 Dec;41(10):4197-201. doi: 10.1016/j.transproceed.2009.08.082.
Life expectancy after transplantation has improved, and cancer may soon be the leading cause of late death after transplantation. The guidelines of the American and European societies of nephrology and urology have not yet established the optimal frequency for screening for renal cell carcinoma (RCC) of native kidneys in patients who have undergone renal transplantation.
To evaluate the prevalence, prognosis, and risk factors of RCC in a series of patients followed up for 16 years in our transplantation unit.
Our study is a follow-up observational cohort study conducted in 694 consecutive renal transplant recipients admitted to our institution from July 1991 through July 2007. At our institution, ultrasound studies of the native kidneys were performed every 6 months after renal transplantation.
In the patient cohort studied, 10 patients developed a renal tumor (1.6% incidence). Three patients died of causes other than recurrence of RCC. Seven patients are alive with no evidence of RCC recurrence or metastatic disease after a mean (range) follow-up of 41 (12-96) months. Acquired cystic kidney disease and dialysis duration were positively associated with development of RCC.
The incidence of RCC in the literature varies between 0.3% and 4.8%. The variability depends on the timing of follow-up, with a higher incidence in prospective studies with strict follow-up. We advise ultrasound studies performed by specialized physicians every 6 months after transplantation. More detailed guidelines designed by the major international transplantation societies are necessary.
移植后的预期寿命有所提高，癌症可能很快成为移植后晚期死亡的主要原因。美国和欧洲肾脏病学会及泌尿外科学会的指南尚未确定肾移植患者中筛查天然肾肾细胞癌（RCC）的最佳频率。
评估在我们的移植单元随访16年的一系列患者中RCC的患病率、预后及危险因素。
我们的研究是一项随访观察性队列研究，纳入了1991年7月至2007年7月期间连续入住我院的694例肾移植受者。在我院，肾移植后每6个月对天然肾进行超声检查。
在所研究的患者队列中，10例患者发生了肾肿瘤（发病率为1.6%）。3例患者死于RCC复发以外的原因。7例患者存活，在平均（范围）41（12 - 96）个月的随访后，无RCC复发或转移性疾病的证据。获得性囊性肾病和透析时间与RCC的发生呈正相关。
文献中RCC的发病率在0.3%至4.8%之间。这种变异性取决于随访时间，在严格随访的前瞻性研究中发病率较高。我们建议移植后每6个月由专科医生进行超声检查。主要国际移植学会制定更详细的指南很有必要。
