Study of urothelial bladder tumours in renal transplant recipients
Neuzillet, Y.; Cabaniols, L.; Karam, G.; Salomon, L.; Barrou, B.ît.; Petit, J.; Feuillu, B.ît.; Lechevallier, E.
Progres en Urologie Journal de l'Association Francaise d'Urologie et de la Societe Francaise d'Urologie 16(3): 343-346
2006
ISSN/ISBN: 1166-7087 PMID: 16821348 Document Number: 596303
To study the prevalence, treatment and outcome of urothelial bladder tumours (UBT) in renal transplant recipients. Multicentre retrospective study performed in 2004 by questionnaire sent to members of the AFU Transplantation Committee. Seven centres returned the questionnaire with a total of 32 UBTs in 21 males and 3 females with a mean age of 63.2 +/- 10.1 years, with no history of UBT. The incidence was 255 per 100,000. The median interval between transplantation and UBT was 60 months (range: 5 to 259 months). 72% of UBTs were stage pT > or = 1 and 63% were grade 3. CIS was present in 20% of cases. 25% of patients were N+. In addition to resection of the UBT, 3 patients were also treated with mitomycin C and 1 was treated with BCG. 7 patients underwent cystectomy, with a palliative objective in 42% of cases, associated with radiotherapy-chemotherapy (2/3) or chemotherapy alone (1/3). Immunosuppressive therapy was decreased in 50% of cases. Six patients (25%) died from bladder cancer, 25% relapsed with a tumour progression rate of 50%. 46% of patients were in remission of their UBT 4% died from an intercurrent cause. 76% of survivors have a Junctional graft with no alteration of serum creatinine. Renal transplant recipients have an increased incidence of UBT, which are more aggressive and associated with a higher mortality compared to the general population. Increased surveillance and aggressive treatment therefore appear to be justified.