Nephron-sparing surgery for renal tumours on kidney transplantation

Abstract

IntroductionNowadays, nephron-sparing surgery for renal carcinoma achieves good oncological results, similar to radical surgery, with the advantage of preserving renal function. Renal cell carcinomas appear de novo in 4.6% of post-transplant patients compared with 3% of tumors in the general population, affecting less than 10% to renal allograft. ObjectiveThe purpose is to analyze our experience and make a literature review about the role of nephron-sparing surgery to treat de novo renal tumours in renal grafts. Material and methodsA retrospective and descriptive analysis has been realized, finding four patients who presented with de novo renal tumours over renal graft after kidney transplantation and treated by nephron-sparing surgery. A Medline review is done to search similar series published. Oncological and functional results were reviewed and analyzed. We worked with SPSS 12.0 software. ResultsMedium age at diagnosis was 46.5 and (42–62). Medium size was 2.4cm. (1.5–3.5) and final histology showed medium tumours size of 3.0cm. (1.7–3.5). Medium hospital stay was 6.0d. Medium time from transplantation to diagnosis was 92 months (42–192). NSS was done in all cases, in 3 cases tumorectomy and one partial nephrectomy. Transfusion was only needed in one case. All cases had pT1aN0M0 RCC histology exam. Renal function did not change from preoperative. All patients are free of progression with a medium follow-up of 46.5 months (15–58). ConclusionsNSS could be an option to treat graft tumours in selected cases, preserving renal function. In our experience, it is a safe and efficient treatment in patients with small de novo renal tumours over renal graft.