PD45-04 OUTCOMES OF GENITOURINARY MALIGNANCY IN SOLID ORGAN TRANSPLANT RECIPIENTS

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery II (PD45)1 Sep 2021PD45-04 OUTCOMES OF GENITOURINARY MALIGNANCY IN SOLID ORGAN TRANSPLANT RECIPIENTS Song Jiang, Brent Cleveland, and Christopher Warlick Song JiangSong Jiang More articles by this author , Brent ClevelandBrent Cleveland More articles by this author , and Christopher WarlickChristopher Warlick More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002059.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The management of genitourinary (GU) malignancy in transplant recipients is challenging and remains controversial, often based on historical practices that fail to take into account recent progress in both genitourinary cancer diagnosis and management, as well as immunosuppression protocols used by modern transplant teams. Data regarding rates and outcomes of GU malignancy in the solid organ transplant (SOT) population is lacking, and studies that exist have small numbers of patients. The purpose of this study is to examine the incidence, disease characteristics, and clinical course of bladder and kidney cancer diagnosed in a large solid organ transplant cohort. METHODS: The University of Minnesota SOT database, curated based on UNOS data collected from 1984–2019, was queried for SOT recipients who subsequently developed bladder cancer and renal neoplasm. A retrospective chart review of available electronic medical records was performed based on the results of this query to obtain patient characteristics, pathology, treatment, and outcomes. RESULTS: In our cohort of SOT recipients, 42 patients were subsequently diagnosed with bladder cancer. High grade and advanced disease (T2 or greater) were present in 27 (64.3%) and 16 (38.1%) of patients, respectively. Recurrences occurred in 17 patients with 6 (35%) of these being progression in disease. Bladder cancer-related deaths occurred in 8 patients (19.1%). The mean overall survival after initial diagnosis was 2.8 (±3.3) years. 111 SOT patients developed a renal neoplasm in the native kidney, whereas 33 developed a neoplasm in a graft kidney. The large majority of renal masses were localized and treated with radical nephrectomy. 2 patients developed progression of disease after radical surgery with evidence of metastasis, while 3 patients had evidence of metastasis on presentation. CONCLUSIONS: Previously, we have described cumulative incidence of genitourinary malignancy in a large cohort of renal transplant recipients at the University of Minnesota. Herein, we present a study of the broader solid organ transplant population and present disease characteristics and outcomes of bladder and kidney cancer patients, which revealed that those diagnosed with de novo bladder malignancy after their transplant had increased rates of high grade and advanced disease (T2 or greater) at initial diagnosis compared to commonly cited rates for the general population, whereas in the case of renal cell cancer we noted an increased rate of diagnosis, but rates of disease progression and metastasis largely in line with the general population. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e743-e743 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Song Jiang More articles by this author Brent Cleveland More articles by this author Christopher Warlick More articles by this author Expand All Advertisement Loading ...