Surgical Treatment of Renal Cell Carcinoma in the Immunocompromised Transplant Patient

Matthew K. Tollefson, Amy Krambeck, Bradley C. Leibovich, Michael L. Blute, George K. Chow

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: To determine whether iatrogenic immunosuppression used after transplantation infers a poor prognosis of renal cell carcinoma (RCC) as natural negative immune regulators have been associated with decreased cancer-specific survival from RCC. Methods: All patients with a solid organ transplant who underwent radical nephrectomy or nephron-sparing surgery for nonhereditary sporadic RCC from 1970 to 2003 were identified and retrospectively reviewed. Results: We identified 17 patients with surgically treated rcc who also underwent a solid organ transplant: 11 with transplant before RCC and 6 with transplant after RCC. Type of transplant included 9 kidney, 3 heart, 3 liver, 1 kidney and liver, and 1 kidney and pancreas. Tumor pathology included 10 clear-cell RCC and 7 papillary RCC. At the last follow-up 6 patients died at a mean of 5.9 years after nephrectomy. Among the 11 patients still alive, mean follow-up was 7.6 years. Only 1 patient died of RCC. This patient had metastatic clear-cell RCC that was completely resected 8 years before renal transplant. He had a recurrence 2 years post transplant and died 3 years after recurrence. No other patients experienced local or distant disease recurrence. Immunosuppression was decreased in only 2 patients; one secondary to RCC metastases and another for recurrent skin cancer. Conclusions: Surgical resection of RCC in transplant patients is associated with a low rate of progression, despite optimal immunosuppression. We recommend surgical resection of low-risk, organ-confined RCC without reduction in immunosuppression in patients with solid organ transplants.

Original languageEnglish (US)
Pages (from-to)1373-1377
Number of pages5
JournalUrology
Volume75
Issue number6
DOIs
StatePublished - Jun 2010
Externally publishedYes

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Immunocompromised Host
Renal Cell Carcinoma
Transplants
Immunosuppression
Therapeutics
Kidney
Nephrectomy
Recurrence
Liver
Nephrons
Skin Neoplasms
Pancreas
Neoplasms
Transplantation
Pathology
Neoplasm Metastasis

ASJC Scopus subject areas

  • Urology

Cite this

Surgical Treatment of Renal Cell Carcinoma in the Immunocompromised Transplant Patient. / Tollefson, Matthew K.; Krambeck, Amy; Leibovich, Bradley C.; Blute, Michael L.; Chow, George K.

In: Urology, Vol. 75, No. 6, 06.2010, p. 1373-1377.

Research output: Contribution to journalArticle

Tollefson, Matthew K. ; Krambeck, Amy ; Leibovich, Bradley C. ; Blute, Michael L. ; Chow, George K. / Surgical Treatment of Renal Cell Carcinoma in the Immunocompromised Transplant Patient. In: Urology. 2010 ; Vol. 75, No. 6. pp. 1373-1377.
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