414P Incidence and characteristics of lung cancer diagnosed after kidney transplantation at the National Kidney and Transplant Institute

Abstract

Kidney transplant recipients have increased risk of malignancy. They are also maintained on immunosuppressive agents which make them prone to infection and makes it more complicated when dealing with cancer in this population. Lung cancer, likewise, is the leading cause of mortality among all cancer types in the general population. It is thus the purpose of this paper to determine the incidence of lung cancer in post kidney transplant patients and provide information on how these patients are managed, as well as describe outcomes in each. A retrospective review of medical records of patients with lung cancer after kidney transplantation at National Kidney and Transplant Institute from January 1983 to December 2018. Incidence and clinicodemographic characteristics were determined. Kidney function after cancer diagnosis were investigated. Overall survival and progression free survival were determined in Kaplan-Meier curves. Only five (n=5) or 0.076% of 6,580 kidney transplant recipients developed lung cancer. Eighty percent (80%) were diagnosed at stage IV. All were diagnosed at symptom onset, and no screening chest CT were done post-transplant. One patient diagnosed at an early stage underwent surgical lobectomy while 2 patients diagnosed at stage IV had undergone chemotherapy. Two patients (40%) had creatinine clearance lower than baseline during the course of lung cancer disease, and one patient (20%) had acute rejection. Median overall survival is 3.4 months (95% CI 0.87 - 12.47). Lung cancer occurred in 0.076% of kidney transplant recipients, and most are in advanced stage. Additional studies are needed to determine association of systemic treatment and survival, as well as adverse reactions of treatment particularly in kidney transplant recipients.