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Incidence of cancer after kidney transplant: results from the North Italy transplant program.
- Source :
-
Transplantation [Transplantation] 2003 Nov 27; Vol. 76 (10), pp. 1448-51. - Publication Year :
- 2003
-
Abstract
- Background: Patients undergoing kidney transplantation demonstrate a higher risk of developing cancer as the result of immunosuppressive treatment and concurrent infections.<br />Methods: The incidence of cancer in a cohort of patients who underwent kidney transplantation between 1990 and 2000, and who survived the acute phase (10 days), was analyzed as part of the North Italy Transplant program.<br />Results: A total of 3,521 patients underwent transplantation during a 10-year period in 10 of 13 participating centers; the length of follow-up after kidney transplant was 67.7+/-36.0 months. During the follow-up, 172 patients developed cancer (39 with Kaposi sarcoma, 38 with lymphoproliferative diseases, and 95 with carcinomas [17 kidney, 11 non-basal cell carcinoma of the skin, 10 colorectal, 8 breast, 7 gastric, 7 lung, 6 bladder, and 3 mesothelioma]). The average time to cancer development after transplant was 40.1+/-33.4 months (range 0-134 months). Twenty-four patients developed cancer within 6 months from the transplant (10 with carcinomas, 7 with Kaposi sarcoma, and 7 with lymphoproliferative diseases). Three patients demonstrated a second primary cancer. The average cancer incidence was 4.9%. The incidence of cancer was 0.01 per year. Independent determinants of cancer development were age, gender, and immunosuppressive protocol including induction. Ten-year mortality was significantly higher in patients with cancer (33.1%) than among patients without cancer (5.3%). The relative risk of death in subjects with cancer was 5.5 (confidence interval 4.1-7.4).<br />Conclusions: These preliminary data underline the importance of long-term surveillance of transplant recipients, choice of immunosuppressive treatment, and careful donor selection.
- Subjects :
- Actuarial Analysis
Female
Follow-Up Studies
Humans
Incidence
Italy
Kidney Neoplasms epidemiology
Kidney Transplantation immunology
Male
Middle Aged
Neoplasms mortality
Risk Factors
Survival Analysis
Time Factors
Kidney Transplantation adverse effects
Neoplasms epidemiology
Postoperative Complications epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 0041-1337
- Volume :
- 76
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 14657684
- Full Text :
- https://doi.org/10.1097/01.TP.0000083897.44391.E8