MP06-17 UROTHELIAL CARCINOMA AFTER KIDNEY TRANSPLANT: A HETEROGENEUS ENTITY IN TERMS OF DIAGNOSIS, TREATMENTS AND ONCOLOGICAL OUTCOMES

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2017MP06-17 UROTHELIAL CARCINOMA AFTER KIDNEY TRANSPLANT: A HETEROGENEUS ENTITY IN TERMS OF DIAGNOSIS, TREATMENTS AND ONCOLOGICAL OUTCOMES Vital Hevia, Javier Lorca, Victoria Gomez, Sara Alvarez, Victor Diez, and Francisco Javier Burgos Vital HeviaVital Hevia More articles by this author , Javier LorcaJavier Lorca More articles by this author , Victoria GomezVictoria Gomez More articles by this author , Sara AlvarezSara Alvarez More articles by this author , Victor DiezVictor Diez More articles by this author , and Francisco Javier BurgosFrancisco Javier Burgos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.262AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cancer development after KT is increasing, and urothelial carcinoma (UCa) incidence has been estimated 3 times higher, especially focused in bladder. However, upper urinary tract (UUT) can also be affected, both in native and less commonly in graft UUT. Management of UCa after KT is demanding because of aggressiveness and potential graft involvement. The aim of the study is to assess all UCa developed after KT, as well as treatments performed and oncological outcomes METHODS Retrospective analysis of 1.693 KT at our institution between 1977-October 2016. Age, sex, tumor location, TNM stage, tumor grade, presence of Cis, treatments and oncological outcomes are assessed, including median Overall Survival (mOS) and cancer-specific-survival (CSS) RESULTS 13 patients developed 14 UCa (0.83%), 61.5% male. Median age at the moment of cancer was 62.5 years (range 40-81) and median time from KT to cancer 52.5 months (range 2-209). UCa were located in bladder (8), in native UUT (1) and in graft UUT (5). At diagnosis, only 1 patient was metastatic and 35% of the cases (5/14) had Cis associated. Regarding tumor grade, 1 was G2, 9 were G3 and 4 were G4. Pathologic stage and treatments performed for UCa after KT are detailed in Table 1. 67% patients with non-muscle-invasive bladder tumor (NMIBT) received BCG. All patients with graft UUT UCa had locally advanced tumors and were treated with graft RNU and pelvic lymphadenectomy, returning to dialysis. At present, 69.2% (9/13) are alive, and median-overall-survival (mOS) is 36 months (range 2-182). Of the total 4 deaths, 1 was cancer-related, 1 during RC postoperative course and the other 2 ESRD-related. Cancer-specific-survival (CSS) was 92% (12/13). CONCLUSIONS Bladder is the most common place of UCa after KT. BCG is also a part of the treatment in these patients. Graft UUT UCa was relatively high in our study comparing to literature. It is usually locally advanced and sometimes unresectable. mOS of UCa after KT is 36 months, which is lower than other uro-cancers in this population. Treatment of this cancer is challenging and can potentially involve the graft, being necessary to remove it and so returning to dialysis © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e79-e80 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Vital Hevia More articles by this author Javier Lorca More articles by this author Victoria Gomez More articles by this author Sara Alvarez More articles by this author Victor Diez More articles by this author Francisco Javier Burgos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...