Palazzetti Anna, Bosio Andrea, Dalmasso Ettore, Destefanis Paolo, Fop Fabrizio, Pisano Francesca, Segoloni Giuseppe, Biancone Luigi, Volpe Alessandro, Di Domenico Antonia, Terrone Carlo, Iesari Samuele, Famulari Antonio, Todeschini Paola, Frea Bruno, Gontero Paolo
Department of Urology, University of Turin, Città della Salute e della Scienza, Turin, Italy.
Department of Nephrology and Dialysis, University of Turin, Città della Salute e della Scienza, Turin, Italy.
Urol Int. 2018;100(2):185-192. doi: 10.1159/000481917. Epub 2018 Jan 17.
Renal transplant recipients (RTRs) have a 2- to 7-fold risk of developing a neoplasm compared to general population. Bladder urothelial neoplasms in this cohort has an incidence of 0.4-2%. Many reports describe a more aggressive behavior. The objective of this study is to describe oncologic characteristics of bladder urothelial neoplasms in RTRs and to evaluate its recurrence, progression, and survival rates.
A retrospective multicentered study was performed evaluating all de novo bladder urothelial neoplasms cases in RTRs from 1988 to 2014. Descriptive statistical analysis and evaluation of recurrence, progression, and survival rates were performed.
A total of 28 de novo bladder transitional cell carcinomas (TCCs) were identified (incidence rate 0.64%). Cancer-specific survival rates were 100, 75, and 70% after 1, 5, and 10 years, respectively. Age at diagnosis superior to 60 years was found to be a statistically significant variable for recurrence risk. Progression rate was 14%. Presence of CIS was significantly associated with progression. All cancer-specific deaths were in the high-risk group and all were progressions from non-muscle invasive to muscle invasive bladder cancer.
Bladder urothelial neoplasms following renal transplant is associated with a trend toward worst prognosis. Early aggressive treatments, such as early radical cystectomy, might be advisable to reduce cancer-specific deaths.
与普通人群相比，肾移植受者（RTR）发生肿瘤的风险高2至7倍。该队列中膀胱尿路上皮肿瘤的发生率为0.4%-2%。许多报告描述了其更具侵袭性的行为。本研究的目的是描述RTR中膀胱尿路上皮肿瘤的肿瘤学特征，并评估其复发、进展和生存率。
进行了一项回顾性多中心研究，评估1988年至2014年RTR中所有新发膀胱尿路上皮肿瘤病例。进行了描述性统计分析以及复发、进展和生存率评估。
共识别出28例新发膀胱移行细胞癌（TCC）（发病率0.64%）。1年、5年和10年后的癌症特异性生存率分别为100%、75%和70%。发现诊断时年龄大于60岁是复发风险的一个具有统计学意义的变量。进展率为14%。原位癌（CIS）的存在与进展显著相关。所有癌症特异性死亡均发生在高危组，且均为从非肌层浸润性膀胱癌进展为肌层浸润性膀胱癌。
肾移植后膀胱尿路上皮肿瘤的预后有变差的趋势。早期积极治疗，如早期根治性膀胱切除术，可能有助于降低癌症特异性死亡。
