腎臟移植後惡性腫瘤：泌尿上皮盛行區域醫院經驗
周主民、周詠欽、沈正煌、林昌德、鄭明進、洪啟峰
戴德森醫療財團法人嘉義基督教醫院 外科部 泌尿科
Post renal transplantation malignancy: high urothelial carcinoma prevalence single regional hospital experience
Chu-Min Chou, Yeong-Chin Jou, Cheng-Huang Shen, Chang-Te Lin, Ming-Chin Cheng, Chi-Feng Hung Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
Purpose: Renal transplantation stands for the best treatment option for patient with end-stage renal disease. However, marked increase of malignancy incidence was well reported in previous article. We reported incidence, characteristic of patients developing malignancies after kidney transplantation at our hospital.
Material and Method: We retrospectively reviewed medical record of patients with renal transplantation receiving follow-up for more than 3 years at our hospital. Patient characteristics including age on regular dialysis, age at transplantation, type of malignancy and other risk factors were reviewed.
Results: A total of 20 patients were identified, with 8 males and 12 females. All patients were not diagnosed with malignancy prior to renal transplantation, and 6 patients developed malignant disease during follow-up. Of the 6 patients with post renal transplantation malignancy, with 2 males and 4 females, 1 developed endometrial carcinoma, 3 developed urothelial carcinoma, 1 male patient developed renal cell carcinoma and 1 male patient developed hepatocellular carcinoma and urothelial carcinoma. The mean age on regular dialysis and at transplantation was 42.83-year-old and 50.33-year-old, separately, compared to 36.57-year-old and 43.14-year-old for patients without malignancy. The mean time from transplantation to diagnosis of malignancy was 8.33 years. Of the six patients with malignancy, no tobacco use nor HBV/ HCV infection was identified. The mean BMI of the six patients was 22.02 kg/m2, compared to 24.38 kg/m2 of the others.
Conclusions: Although relatively small number of patients, certain characteristic such as higher incidence of urothelial carcinoma in post renal transplantation, was compatible to previous Taiwan local article. Higher age at transplantation might be another factor related to post renal transplantation malignancy. The impact of other important factors, such as type of immunosuppressant, carcinoma inducing virus should be studied in larger cohort.