Urothelial carcinoma following renal transplantation(Report of 25 cases)

Abstract

Objective To summarize features of urothelial carcinoma in renal allograft recipients and investigate the measures of diagnosis and treatment. Methods A retrospective study was undertaken on 25 renal allograft recipients with urothelial carcinoma in our center between 1998 and 2006. To analysis sexuality, age, protopathy, time of the tumor occurred, symptom, the location of tumor and turnover respectively. All the cases didn't have tumor before transplantation. The primary examinational methods are the imaging and cystoscope. Surgical treatment was carried out in 22 cases. All the 22 cases reduced one third of the dosage of immunos.uppressant and performed intravesical instillation chemotherapy. Results There are 4 males and 21 females in the 25cases; The average age is 55.1; There were 19 cases which protopathy were chronic interstitial nephritis(CIN); The interval between tumorigenesis and transplantation was 26 months; There are 25 cases with gross or microscopic hematuria, 10 cases with iterative urinary tract infection, and 12 cases with renal pelvis and ureter stretch; There are 22 cases with multiple tumors and 16 cases with tumor(s) of upper urinary tract the same-side of graft. 3 cases without surgical treatment had died respectively 5, 6 and 8 month after diagnosed. 22 cases with surgical treatment were followed up from 2 to 7 years. 18 cases had tumor recurrence and received operation again. All the patients did not occur the acute rejection during decreased the dosage of immunosuppressant and have normal renal function.Conclusions Renal allograft recipients whose protopathy were chronic interstitial nephritis (CIN) and female recipients may be the risk factors of the disease. The hematuria, urinary tract infection and stretch are common symptoms. The multi-tumor and recurrence are the other clinical features. The upper urinary tract with same-side graft is easy to involve urothelial carcinoma. Key words: Renal transplantation ; Urothelial carcinoma ;