Department of Anal and Colorectal Surgery, Shanxi Cancer Hospital, Affiliated Cancer Hospital of Shanxi Medical University, Taiyuan 030013, Shanxi Province, China.
World J Gastroenterol. 2011 Apr 21;17(15):2058-60. doi: 10.3748/wjg.v17.i15.2058.
Renal transplantation is a standard procedure for end-stage renal disease today. Due to immunosuppressive drugs and increasing survival time after renal transplantation, patients with transplanted kidneys carry an increased risk of developing malignant tumors. In this case report, 3 patients with advanced rectal cancer after renal transplantation for renal failure were treated with anterior resection or abdominoperineal resection plus total mesorectal excision, followed by adjuvant chemotherapy. One patient eventually died of metastasized cancer 31 mo after therapy, although his organ grafts functioned well until his death. The other 2 patients were well during the 8 and 21 mo follow-up periods after rectal resection. We therefore strongly argue that patients with advanced rectal cancer should receive standard oncology treatment, including operation and adjuvant treatment after renal transplantation. Colorectal cancer screening in such patients appears justified.
肾移植是目前治疗终末期肾病的标准方法。由于免疫抑制药物的应用以及肾移植后患者生存时间的延长，移植肾患者发生恶性肿瘤的风险增加。本病例报告中，3 例因肾衰竭接受肾移植后发展为晚期直肠癌的患者接受了直肠前切除术或腹会阴联合切除术加全直肠系膜切除术，然后进行辅助化疗。尽管患者的器官移植物在其死亡前一直正常运行，但其中 1 例患者在治疗后 31 个月时最终死于转移性癌症。另外 2 例患者在直肠切除术后 8 个月和 21 个月的随访期间情况良好。因此，我们强烈主张晚期直肠癌患者应接受标准的肿瘤治疗，包括在肾移植后进行手术和辅助治疗。对这类患者进行结直肠癌筛查似乎是合理的。
