Incidence of cancer after kidney transplant: Results from the North Italy transplant program

Paola Pedotti, Massimo Cardillo, Giuseppe Rossini, Valentino Arcuri, Luigino Boschiero, Rossana Caldara, Giuseppe Cannella, Daniela Dissegna, Eliana Gotti, Francesco Marchini, Maria Cristina Maresca, Giuseppe Montagnino, Domenico Montanaro, Paolo Rigotti, Silvio Sandrini, Emanuela Taioli, Mario Scalamogna

Research output: Contribution to journalArticle

Abstract

Background. Patients undergoing kidney transplantation demonstrate a higher risk of developing cancer as the result of immunosuppressive treatment and concurrent infections. 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. 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 mesotheliomal). 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). Conclusions. These preliminary data underline the importance of long-term surveillance of transplant recipients, choice of immunosuppressive treatment, and careful donor selection.

Original languageEnglish
Pages (from-to)1448-1451
Number of pages4
JournalTransplantation
Volume76
Issue number10
DOIs
Publication statusPublished - Nov 27 2003

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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    Pedotti, P., Cardillo, M., Rossini, G., Arcuri, V., Boschiero, L., Caldara, R., Cannella, G., Dissegna, D., Gotti, E., Marchini, F., Maresca, M. C., Montagnino, G., Montanaro, D., Rigotti, P., Sandrini, S., Taioli, E., & Scalamogna, M. (2003). Incidence of cancer after kidney transplant: Results from the North Italy transplant program. Transplantation, 76(10), 1448-1451. https://doi.org/10.1097/01.TP.0000083897.44391.E8