Peng Chao, Wang Weihao, Chen Jiajun, Pan Shouhua, Xu Gang, Li Mengyao, Zhang Lulu, Li Yulei, Zhao Keyuan, Jin Jing
Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Department of Pathology, Shaoxing People's Hospital, Shaoxing, China.
J Int Med Res. 2024 Dec;52(12):3000605241304640. doi: 10.1177/03000605241304640.
renal transplant carcinoma, especially in the context of bilateral renal carcinoma, is rare and often presents as small, low-grade papillary renal cell carcinoma (RCC). There is currently no consensus or effective treatment for advanced metastatic RCC after kidney transplantation. A 40-year-old man developed renal transplant carcinoma with venous thrombus and lung metastases 13 years after transplantation. The patient underwent cytoreductive nephrectomy followed by sequential treatment with tyrosine kinase inhibitors (TKI) and anti-PD-1 monoclonal antibodies. After 2 years, the patient showed excellent graft function with no evidence of cancer progression. Despite subsequent graft failure, the disease remained controlled for more than 2 years and the patient survived for more than 3 years, which was significantly longer than the typical survival of 10 to 20 months in patients with advanced kidney cancer. The results suggest that combining cytoreductive nephrectomy with TKI and anti-PD-1 therapy may significantly prolong survival in patients with renal allograft carcinoma.
肾移植癌，尤其是双侧肾癌的情况下，较为罕见，通常表现为小的、低级别乳头状肾细胞癌（RCC）。目前对于肾移植后晚期转移性RCC尚无共识或有效的治疗方法。一名40岁男性在移植13年后发生了伴有静脉血栓和肺转移的肾移植癌。该患者接受了减瘤性肾切除术，随后序贯使用酪氨酸激酶抑制剂（TKI）和抗PD-1单克隆抗体治疗。2年后，患者移植肾功能良好，无癌症进展迹象。尽管随后移植失败，但疾病仍得到控制超过2年，患者存活超过3年，这明显长于晚期肾癌患者典型的10至20个月生存期。结果表明，减瘤性肾切除术联合TKI和抗PD-1治疗可能显著延长肾移植癌患者的生存期。
