Rodríguez Faba O, Breda A, Gausa L, Palou J, Villavicencio H
Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España; Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Barcelona, España.
Unidad de Trasplante Renal, Servicio de Urología, Fundació Puigvert, Barcelona, España; Unidad de Urología Oncológica, Servicio de Urología, Fundació Puigvert, Barcelona, España.
Actas Urol Esp. 2015 Mar;39(2):122-7. doi: 10.1016/j.acuro.2014.05.002. Epub 2014 Jul 2.
CONTEXT: The ability of a transplant recipient to accept a graft depends on the ability of immunosuppressive drugs to regulate the immune system. Such treatments have been associated with tumor promotion and progression. EVIDENCE ACQUISITION: A systematic literature review was carried out. Electronic searches were performed in PubMed database. The searching criterion was "urological tumors in kidney transplant recipients". The most important issues regarding incidence, urological tumor-specific features, and relevant ones about the treatment are summarized. SYNTHESIS OF EVIDENCE: In renal transplant, 15% of all tumors are urological neoplasias; furthermore, they are the leading neoplastic cause of death. In transplant population the incidence rate of renal cell carcinoma (RCC), transitional cell bladder carcinoma (TCBC), testicular carcinoma (TC) and prostate cancer are increased 15, 3, 3 and 2 times respectively. Treatments used in transplant patients are similar to those employed in the general population:radical nephrectomy for the native kidney and conservative surgery for the graft are indicated for RCC. Radical prostatectomy is technically feasible for localized PC.Regarding to transitional cell carcinoma BCG or MMC is not contraindicated. CONCLUSIONS: The incidence rate of cancer has increased among transplant population. These tumors can be managed following the same criteria than in general population. Because in this population the prognosis is worse for the immunosuppression, closer monitoring is required.
背景:移植受者接受移植物的能力取决于免疫抑制药物调节免疫系统的能力。此类治疗与肿瘤的促进和进展有关。 证据获取:进行了系统的文献综述。在PubMed数据库中进行了电子检索。检索标准为“肾移植受者中的泌尿系统肿瘤”。总结了有关发病率、泌尿系统肿瘤特异性特征以及治疗相关的最重要问题。 证据综合:在肾移植中,所有肿瘤中有15%是泌尿系统肿瘤;此外,它们是肿瘤死亡的主要原因。在移植人群中,肾细胞癌(RCC)、移行细胞膀胱癌(TCBC)、睾丸癌(TC)和前列腺癌的发病率分别增加了15倍、3倍、3倍和2倍。移植患者使用的治疗方法与普通人群相似:RCC患者,对于原肾行根治性肾切除术,对于移植肾行保守手术。对于局限性前列腺癌,根治性前列腺切除术在技术上是可行的。对于移行细胞癌,卡介苗或丝裂霉素不属禁忌。 结论:移植人群中的癌症发病率有所增加。这些肿瘤可以按照与普通人群相同的标准进行处理。由于该人群因免疫抑制预后较差,需要进行更密切的监测。
Actas Urol Esp. 2015-3
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