Yu Jiwoong, Lee Chung Un, Kang Minyong, Jeon Hwang Gyun, Jeong Byong Chang, Seo Seong Il, Jeon Seong Soo, Lee Hyun Moo, Sung Hyun Hwan
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea,
Cancer Manag Res. 2018 Dec 24;11:157-166. doi: 10.2147/CMAR.S185796. eCollection 2019.
We investigated to determine if there is an increased rate of urothelial carcinoma (UC) in kidney transplant (KT) recipients and to compare oncological outcomes of UC in KT recipients with non-KT patients.
Among 2,186 patients who underwent KT in our institute, nine patients developed UC after KT in our center. Age-standardized rates (ASRs) were calculated to compare incidence rates of UC between KT patients and the general population. Additional five patients who underwent KT at other hospitals and received UC treatment at our center were included, thus a total of 14 KT patients were compared with non-KT patients in the aspect of the treatment outcomes of bladder cancer and upper urinary tract UC (UTUC) by using generalized estimating equation (GEE).
The ASRs of bladder cancer and UTUC in KT recipients were 25.5 and 129.5 times higher than that of the general population. Although there was no difference in bladder cancer-specific survival rates (-value 0.1186), however, progression rates of bladder cancer were significantly higher in KT recipients with a relative risk of 10.53 (-value 0.0481). There was no significant difference in UTUC recurrence, progression, and specific survival rate (-values 0.8915, 0.8806, and 0.8116, respectively).
Incidence of UC was much higher in KT recipients than the general population. Treatment outcomes for UC in KT recipients were not inferior to those of non-KT patients, except for the progression of bladder cancer. Special attention should be paid to screening and treatment of UC in KT recipients.
我们进行研究以确定肾移植(KT)受者中尿路上皮癌(UC)的发病率是否增加,并比较KT受者与非KT患者中UC的肿瘤学结局。
在我院接受KT的2186例患者中,有9例在我院中心接受KT后发生了UC。计算年龄标准化率(ASR)以比较KT患者与普通人群中UC的发病率。纳入另外5例在其他医院接受KT并在我院中心接受UC治疗的患者,因此总共14例KT患者与非KT患者在膀胱癌和上尿路UC(UTUC)治疗结局方面进行比较,采用广义估计方程(GEE)。
KT受者中膀胱癌和UTUC的ASR分别比普通人群高25.5倍和129.5倍。尽管膀胱癌特异性生存率无差异(P值0.1186),然而,KT受者中膀胱癌的进展率显著更高,相对风险为10.53(P值0.0481)。UTUC的复发、进展和特异性生存率无显著差异(P值分别为0.8915、0.8806和0.8116)。
KT受者中UC的发病率远高于普通人群。KT受者中UC的治疗结局除膀胱癌进展外并不劣于非KT患者。应特别关注KT受者中UC的筛查和治疗。