Neoplasma. 2017;64(2):311-317. doi: 10.4149/neo_2017_220.
Malignancies are one of the three major causes of renal recipient´s death with a functioning graft after cardiovascular diseases and infections. Among the variety of risk factors, including conventional and specific to transplant recipients, the duration of immunosuppressive therapy, the intensity of therapy, and the type of immunosuppressive agent all have an impact on development of post-transplant malignancy. The aim of our retrospective study was to document the incidence, the type of malignancies, the patient/graft survival in the group of kidney transplant recipients in Slovak Republic, and to identify the factors which influenced the outcome. We analyzed the data of 1421 patients who underwent renal transplantation from deceased or living donors in the period from 2007 to 2015 in the Slovak transplant centers. The incidence of malignant tumors was 6%, the malignancy was diagnosed in 85 patients at the age of 54.1 ± 9.8 years, more frequently in men (68.2 %; P < 0.0001). The mean time of malignancy occurrence was 45 months after transplantation. The most frequent malignancies were skin cancers- basal cell carcinoma (BCC) in 17.6%, squamous cell carcinoma (SCC) in 8.2%, and malignant melanoma (MM) in 2.4% of patients, followed by non-skin tumors such as renal cell carcinoma (RCC) in 16.5%, cancer of colon in 12.9%, prostatic cancer in 9.4%, breast cancer in 9.4%, cancer of lung in 7.1%, post-transplant lymphoproliferative disease (PTLD) in 2.4%, cancer of urine bladder in 2.4%, and cancer of sublingual gland in 1.17% of patients. Surgical treatment was used in 40% of patients, chemotherapy in 7.1%, radiotherapy in 2.4%, treatment with biological agents in 15.3%, combined therapy in 29.4% and palliative treatment in 5.9% of patients. 55.3% of patients underwent conversion from other immunosuppressive agents into mTORi at the time of malignancy occurrence. The remission was achieved in 48.2% of patients, 28.2% of patients were in the oncology treatment in the end of the year 2015, and 23.5% of patients died. There was no difference in the kidney function at the time of malignancy occurrence (s-creat 133.7 ± 59.8 µmol/l) and one year later (s-creat 131.1 ± 47.9 µmol/l) (P = 0.7768). The patients after successful treatment more frequently suffered from BCC (P = 0.0140), did not undergo palliative treatment (P = 0.0033), but were more frequently treated surgically (P < 0.0001).
恶性肿瘤是心血管疾病和感染后导致肾移植受者移植肾功能丧失的三大原因之一。在包括传统和移植受者特有的各种危险因素中，免疫抑制治疗的持续时间、治疗强度和免疫抑制剂类型都对移植后恶性肿瘤的发展有影响。我们回顾性研究的目的是记录在斯洛伐克共和国的肾移植受者中恶性肿瘤的发病率、类型、患者/移植物存活率，并确定影响结果的因素。我们分析了 2007 年至 2015 年期间在斯洛伐克移植中心接受来自已故或活体供体的 1421 例患者的肾移植数据。恶性肿瘤的发病率为 6%，85 例患者在 54.1 ± 9.8 岁时被诊断出患有恶性肿瘤，其中男性更为常见（68.2%；P < 0.0001）。恶性肿瘤发生的平均时间为移植后 45 个月。最常见的恶性肿瘤是皮肤癌——基底细胞癌（BCC）占 17.6%，鳞状细胞癌（SCC）占 8.2%，恶性黑色素瘤（MM）占 2.4%，其次是非皮肤肿瘤，如肾细胞癌（RCC）占 16.5%，结肠癌占 12.9%，前列腺癌占 9.4%，乳腺癌占 9.4%，肺癌占 7.1%，移植后淋巴组织增生性疾病（PTLD）占 2.4%，膀胱癌占 2.4%，舌下腺癌占 1.17%。40%的患者接受了手术治疗，7.1%的患者接受了化疗，2.4%的患者接受了放疗，15.3%的患者接受了生物制剂治疗，29.4%的患者接受了联合治疗，5.9%的患者接受了姑息治疗。55.3%的患者在发生恶性肿瘤时已从其他免疫抑制剂转换为 mTORi。48.2%的患者达到缓解，2015 年底仍有 28.2%的患者在接受肿瘤治疗，23.5%的患者死亡。恶性肿瘤发生时（s-creat 133.7 ± 59.8 µmol/l）和一年后（s-creat 131.1 ± 47.9 µmol/l）的肾功能无差异（P = 0.7768）。成功治疗后的患者更常患有 BCC（P = 0.0140），未接受姑息治疗（P = 0.0033），但更常接受手术治疗（P < 0.0001）。
