As morbidity and mortality from graft dysfunction and failure after kidney transplantation have declined, transplant-related malignancies have become one of the most significant sources of post-transplant complications. Currently, cancer is a major factor limiting the life expectancy of kidney transplant patients, and cancer management is now a crucial component of their medical care.
Studies show that the incidence of de novo malignancies is generally 3 to 4 times higher in transplant recipients than in the general population. For specific types of cancers, the excess incidence relative to the general population can bee several hundred times greater. (see paper "Cancer and Renal Transplantation ASM_7_13_p411-419")
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Transplant Proc. 2005 Mar;37(2):962-3
Skin cancer following transplantation: the Israel Penn International Transplant Tumor Registry experience.
Buell JF1, Hanaway MJ, Thomas M, Alloway RR, Woodle ES.
Abstract: The purpose of this study was to analyze a large series of skin cancers in solid organ transplant recipients to determine their biologic behavior.
Transplant recipients from the United States with skin malignancies were identified (n = 2018) and assigned to 1 of 3 groups: squamous cell cancer (SCC), basal cell cancer (BCC), or combined malignancies (BCC/SCC). Squamous cell to basal cell cancer ratio was found to be 1.9 to 1. The ratio of extrarenal to renal allograft recipients was identical for all 3 groups (3:1). The median interval from transplant to skin cancer diagnosis was greater than 4 years in each group and longest in those with isolated SCC lesions. In the SCC group, there was a 9% incidence of nodal or secondary site involvement affecting the cervix, perineum, or lung. The highest recurrence rate was demonstrated in the combined malignancy group. Cancer-specific deaths were significantly higher in the SCC (8%) and BCC/SCC (6.8%) groups compared to the BCC (3.6%) group.
This large experience indicates that SCC is more common than BCC in transplant recipients. SCC alone or in combination with BCC appears aggressive and is associated with significant mortality.
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Kidney Transplantation and Cancer
- De novo breast cancer in renal transplant recipients. Transplant Proc 2002 Aug;34(5):1778–9.
- Penn I: Cancer and kidney transplantation. In Kidney Transplantation (ed Toledo-Pereyra LH) Philadelphia, F.A. Davis Company, pp. 205–214, 1988.
- Penn I. Cancers in renal transplant recipients. Adv Ren Replace Ther. 2000;7(2):147–56.
- Penn I: Kidney transplantation following treatment of tumors. Transplant Proc 18(Suppl 3):16–20, 1986.
- Penn I: Renal transplantation and cancer. In Proceedings of the 8th International Congress of Nephrology. (eds Zurukzoglu W, Papdimitriou M, Pyrapasopoulos M, Sion M and Zamboulis C) Basel, S. Karger, pp. 527–538, 1981.
- Penn I: Renal transplantation in patients with pre-existing malignancies. Transplant Proc 15:1079–1082, 1983.
- Penn I: The effect of renal transplantation in patients with a history of curative cancer therapy. In Cellular immune mechanisms and tumor dormancy (eds Stewart THM and Wheelock EF) Boca Raton CRC Press, pp. 239–260, 1992.
- Penn I: Tumors after renal and cardiac transplantation. Hematology-Oncology Clin N Amer 7:431–445, 1993.
- Schneck SA, Penn I: De novo cerebral neoplasms in renal transplant recipients. Lancet 1:983–986, 1971.
- Schroter GPJ, Weil R III, Penn I, Speers WC, Waddell WR: Hepatocellular carcinoma associated with chronic hepatitis B virus infection after kidney transplantation (Letter to the Editor) Lancet 2:381–382, 1982.
DISCLAIMER: The content of this TRIO post-transplant cancer Web site is not influenced by sponsors. The site is designed primarily for use by transplant recipients and their supporters. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with your transplant team or a physician skilled in cancer and your organ type if you suspect you are ill.