Moldoveanu Oana, Baston Cătălin, Sorohan Bogdan, Discalicău Lucas, Sinescu Ioanel
Department of Urology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Fundeni Clinical Institute, Center of Surgical Urology and Kidney Transplantation, Bucharest, Romania.
J Med Life. 2025 Apr;18(4):357-363. doi: 10.25122/jml-2025-0065.
Renal cell carcinoma (RCC) is the most common solid-organ malignancy in Western countries, and upper tract urothelial carcinoma (UTUC) is the most common malignancy in Asian countries. The management of RCC/UTUC in kidney transplant recipients is complex and clinically challenging due to post-transplant modifications associated with immunosuppressive treatment. This retrospective study evaluated the incidence, risk factors, treatment outcomes, and oncological implications of RCC and UTUC in kidney transplant recipients from 2008 to 2023. Data were collected from clinical records, and follow-up calls for 20 patients diagnosed with RCC and UTUC among 2,283 kidney transplant recipients, revealing an incidence rate of 0.78% for RCC (18 patients) and 0.087% (two patients) for UTUC. Most patients presented localized disease at diagnosis. Surgical interventions included radical nephrectomy for the native kidney's RCC, radical or partial nephrectomy for allograft RCC, and radical nephroureterectomy for UTUC in the native kidney and allograft. Oncological outcomes indicated a mean follow-up of 51.29 months, during which five patients (25%) developed metastases, which achieved prolonged survival through surgical management, adjuvant therapy, and immunosuppression adjustments. The study highlights the increased cancer risk in this population and underscores the necessity for established screening protocols and individualized treatment strategies to optimize patient outcomes while preserving kidney function. These findings contribute to the ongoing research on managing malignancies in transplant recipients, with implications for further research and clinical guidelines.
肾细胞癌（RCC）是西方国家最常见的实体器官恶性肿瘤，而上尿路尿路上皮癌（UTUC）是亚洲国家最常见的恶性肿瘤。由于免疫抑制治疗相关的移植后改变，肾移植受者中RCC/UTUC的管理复杂且具有临床挑战性。这项回顾性研究评估了2008年至2023年肾移植受者中RCC和UTUC的发病率、危险因素、治疗结果及肿瘤学影响。数据从临床记录中收集，并对2283名肾移植受者中诊断为RCC和UTUC的20名患者进行随访电话调查，结果显示RCC的发病率为0.78%（18例患者），UTUC的发病率为0.087%（2例患者）。大多数患者在诊断时表现为局限性疾病。手术干预包括对自体肾RCC行根治性肾切除术、对移植肾RCC行根治性或部分肾切除术，以及对自体肾和移植肾中的UTUC行根治性肾输尿管切除术。肿瘤学结果显示平均随访51.29个月，在此期间5名患者（25%）发生转移，通过手术治疗、辅助治疗和免疫抑制调整实现了延长生存期。该研究强调了这一人群中癌症风险的增加，并强调了建立筛查方案和个体化治疗策略的必要性，以在保留肾功能的同时优化患者预后。这些发现有助于正在进行的关于移植受者恶性肿瘤管理的研究，对进一步研究和临床指南具有启示意义。
