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Moses KA, Bochner BH, Prabharasuth D, Sfakianos JP, Bernstein M, Herr HW, Dalbagni G. Radical cystectomy and orthotopic urinary reconstruction in patients with bladder cancer after renal transplantation: clinical outcomes and description of technique. Transplant Proc 2013; 45:1661-6. [PMID: 23726643 DOI: 10.1016/j.transproceed.2012.10.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 10/30/2012] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Radical cystectomy (RC) with pelvic lymph node dissection and urinary diversion is the standard treatment for muscle-invasive bladder cancer. In the setting of prior renal transplantation, surgical treatment remains the mainstay but is technically challenging. We report our patient outcomes in this unique population with a description of the technique. METHODS We identified five patients with a history of renal transplantation who underwent RC and orthotopic urinary diversion. Preoperative clinical and demographic features were compiled and disease-specific and functional outcomes were assessed. Intraoperative technical challenges and maneuvers for avoiding complications are highlighted. RESULTS Four patients were male and one was female, with a median age of 64 years. Gross hematuria was the most common sign at presentation. Clinical staging was T2, T2 with carcinoma in situ (CIS), high-grade (HG) Ta with CIS, T2 with squamous differentiation, and HG T1, and pathologic tumor stage was pTisN1, pT3N0, pTisN0, pT3N0, and pT0N0, respectively. One patient received a Studer-type diversion and four underwent Hautmann diversion. Median follow-up after cystectomy was 12.9 months. Graft ureteral identification was aided by the use of intravenous dye in all patients. Ipsilateral pelvic lymph node dissection was not possible in any patient. All patients are alive at follow-up, with two experiencing recurrence at 7.2 months and 66.8 months. No patient experienced a significant decrease in estimated creatinine clearance postoperatively. Postoperative daytime control was reported by all patients whereas two noted complete nighttime control. CONCLUSIONS RC with orthotopic diversion is a technically demanding procedure in patients with a history renal transplantation. Meticulous technique and careful attention to the altered anatomy are required for successful outcomes.
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Affiliation(s)
- K A Moses
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Rogers A, Koo Ng J, Glendinning J, Rix D. The management of transitional cell carcinoma (TCC) in a European regional renal transplant population. BJU Int 2012; 110:E34-40. [DOI: 10.1111/j.1464-410x.2011.10777.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Moon KC, Soo Ahn H, Min SH, Kim HS, Ku JH. Orthotopic ileal neobladder reconstruction in a woman who developed squamous cell carcinoma of the urinary bladder after kidney transplantation. TUMORI JOURNAL 2011; 97:20e-3e. [PMID: 22158504 DOI: 10.1177/030089161109700524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
The case of a 62-year-old woman who developed squamous cell carcinoma of the bladder 16 years after a kidney transplant is reported here. After the transplant, immunosuppressive therapy was maintained with cyclosporin A (200 mg/day) and the patient's serum creatinine level was 0.9 mg/dL. She was diagnosed with squamous cell carcinoma of the bladder 16 years later and underwent radical cystectomy with an orthotopic ileal neobladder. The Studer technique was used and the afferent ileal loop was anastomosed to the graft ureter. The postoperative course was uneventful. At the 6-month follow-up visit, the patient showed no evidence of recurrence. Her serum creatinine level was 1.0 mg/dL. The patient was continent during the day and the night. This case shows that the construction of an orthotopic ileal neobladder after cystectomy is safe and feasible in kidney transplant recipients.
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Affiliation(s)
- Kyung Chul Moon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
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Manassero F, Di Paola G, Mogorovich A, Giannarini G, Boggi U, Selli C. Orthotopic bladder substitute in renal transplant recipients: experience with Studer technique and literature review. Transpl Int 2011; 24:943-8. [PMID: 21722198 DOI: 10.1111/j.1432-2277.2011.01292.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Renal transplant recipients with high-risk bladder cancer following cystectomy need a urinary diversion preserving the renal function and possibly maintaining body image, while still offering the best oncological outcome. The aim of this report is to describe our experience of radical cystectomy and orthotopic ileal neobladder with Studer technique in this population, and to review the literature. We performed radical cystectomy and Studer ileal neobladder in four male patients (median age 67 years) after median time of 9.5 years following renal transplantation. Pathology revealed pT1HGN+ transitional cell carcinoma in one case, pT1HGN0 in two and pT3aHGN0 in one. Two patients presenting aggressive disease (N+ and pT3a) died of tumour progression after 20 and 14 months, respectively, while the other two are alive after 56 and 36 months of follow-up with no evidence of disease, stable serum creatinine (2.29 and 1.6 mg/dl) and mild metabolic acidosis. Day and night-time urinary continence were satisfactory in all patients. Good functional outcomes have been reported in the 20 cases of ileal orthotopic neobladder with different techniques published so far and the global experience of 24 cases with a median follow-up of 39 months documents a cancer specific survival of 62.5%.
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Affiliation(s)
- Francesca Manassero
- Department of Urology, University of Pisa, Nuovo Ospedale Santa Chiara, Presidio di Cisanello, via Paradisa 2, Pisa, Italy.
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Management of Bladder Cancer following Solid Organ Transplantation. Adv Urol 2011; 2011:256985. [PMID: 21603201 PMCID: PMC3095402 DOI: 10.1155/2011/256985] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 02/08/2011] [Accepted: 02/21/2011] [Indexed: 01/20/2023] Open
Abstract
Objective. Present our experience managing bladder cancer following liver and renal transplantation. Methods. Single institution retrospective review of patients diagnosed with bladder urothelial carcinoma (BUC) following solid organ transplantation between January 1992 and December 2007. Results. Of the 2,925 renal and 2,761 liver transplant recipients reviewed, we identified eleven patients (0.2%) following transplant diagnosed with BUC. Two patients with low grade T1 TCC were managed by TURBT. Three patients with CIS and one patient with T1 low grade BUC were treated by TURBT and adjuvant BCG. All four are alive and free of recurrence at a mean follow-up of 51 ± 22 months. One patient with T1 high grade BUC underwent radical cystectomy and remains disease free with a follow-up of 98 months. Muscle invasive TCC was diagnosed in four patients at a median of 3.6 years following transplantation. Two patients are recurrence free at 24 and 36 months following radical cystectomy. Urinary diversion and palliative XRT were performed in one patient with un-resectable disease. Conclusions. Bladder cancer is uncommon following renal and liver transplantation, but it can be managed successfully with local and/or extirpative therapy. The use of intravesical BCG is possible in select immunosuppressed patients.
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Ye J, Ma L, Huang Y, Hou X, Xiao C, Zhao L, Wang G, Hong K, Lu J. Retroperitoneal laparoscopic nephroureterectomy with bladder cuff excision for native upper tract transitional cell carcinoma ipsilateral to a transplanted kidney. Urology 2010; 76:1395-9. [PMID: 20430425 DOI: 10.1016/j.urology.2010.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 11/28/2009] [Accepted: 01/14/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We present preliminary experience of retroperitoneal laparoscopic nephroureterectomy (RPLNU) with bladder cuff excision by combining cystoscopic resection with open transperitoneal dissection for native upper urinary tract transitional cell carcinoma (UUT-TCC) ipsilateral to a transplanted kidney. METHODS Thirteen renal recipients with native UUT-TCC ipsilateral to a transplanted kidney were operated on with RPLNU between November 2005 and August 2008. Retroperitoneal laparoscopic nephrectomy was performed first and followed by cystoscopic excision of ipsilateral ureteral orifice with bladder cuff. A 6-cm midline lower abdominal incision was made. The distal ureter was dissected transperitoneally into the intramural segment, and the intact specimen was removed manually via the same incision. The cystostomy was generally not sutured. RESULTS The mean operation time was 264 minutes. The mean estimated blood loss was 256 mL. Three patients needed blood transfusion. No open conversion was required. Two patients experienced minor complications. Pathologic findings confirmed UUT-TCC in all patients with 8 of the pelvis and 7 of the ureter. Four were involved with bladder TCC. With the mean follow-up of 30 months, none of the patients developed retroperitoneal recurrence or distant metastasis, 2 of the 4 patients with bladder TCC had recurrence in the bladder, and 2 had contralateral UUT-TCC after the first unilateral nephroureterectomy. CONCLUSIONS RPLNU with bladder cuff excision by combining cystoscopic resection with open transperitoneal dissection might be a safe and feasible alternative for native UUT-TCC ipsilateral to a transplanted kidney with acceptable oncological outcomes.
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Affiliation(s)
- Jianfei Ye
- Department of Urology, Peking University Third Hospital, Beijing, China
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Zani D, Simeone C, Arrighi N, Perucchini L, Antonelli A, Setti C, Sandrini S, Cancarini G, Cosciani Cunico S. Radical Cystectomy for Transitional Cell Carcinoma with Orthotopic Neobladder in Renal Transplant Recipients: Surgical Procedure, Functional and Therapeutic Evaluation. Urologia 2009. [DOI: 10.1177/039156030907600307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Transitional Cell Carcinoma (TCC) shows a high prevalence in renal tranplant recipients, nevertheless urinary reconstruction by way of orthotopic neobladder is rarely reported. Patients and Methods Two kidney transplant patients (1 man and 1 woman) affected by TCC underwent radical cystectomy and urinary reconstruction by neobladder according to the “Vescica Ileale Padovana” technique. Results and Discussion No patients claimed incontinence or urine retention. The spherical rebuilding assured an adequate bladder capacity and a low endovesical pressure. After 48 months one patient died because of disease progression. The first relapse was detected in ureter two years after cystectomy. The other patient is still alive after 40 months and in good health conditions. Conclusions This anecdotal report suggests that the “Vescica Ileale Padovana” technique could be useful in renal transplant recipients with TCC. A possible role of Rapamycin on our results cannot yet be excluded.
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Affiliation(s)
- D. Zani
- Department of Urology, University of Brescia
| | - C. Simeone
- Department of Urology, University of Brescia
| | - N. Arrighi
- Department of Urology, University of Brescia
| | | | | | - C. Setti
- Section of Nephrology, University of Brescia and Division of Nephrology, Spedali Civili di Brescia, Brescia
| | - S. Sandrini
- Department of Urology, University of Brescia
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Shirakawa H, Ishida H, Hashimoto Y, Omoto K, Shimizu T, Setoguchi K, Iida S, Toki D, Tanabe K. Continent Orthotopic Ileal Neobladder After Kidney Transplantation in a Patient With Urothelial Cell Carcinoma Associated With Chinese Herb Nephropathy. Transplant Proc 2008; 40:1741-3. [DOI: 10.1016/j.transproceed.2008.02.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2007] [Revised: 02/03/2008] [Accepted: 02/26/2008] [Indexed: 10/21/2022]
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Cooke T, Ciancio G, Burke GW, Soloway MS, Manoharan M. Orthotopic ileal neobladder reconstruction after renal transplant. Am J Transplant 2007; 7:2630-3. [PMID: 17725679 DOI: 10.1111/j.1600-6143.2007.01951.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Radical cystectomy and urinary diversion is an effective curative treatment for muscle invasive bladder cancer. The orthotopic ileal neobladder has become a favorable choice of urinary diversion as it offers superior quality of life, cosmetic outcome and the potential for normal voiding. We treated two patients with bladder cancer who previously underwent renal transplant for end-stage renal disease. Radical cystectomy and orthotopic ileal neobladder reconstruction was performed in both patients. One patient had two renal transplants and underwent transplant nephrectomy at the time of cystectomy. In the other patient, the native kidneys were still present and the ureters were anastomosed to the neobladder. There is excellent function of the neobladder. There were no increased complications seen in these patients. Our cases demonstrate that an orthotopic ileal neobladder is safe and feasible after renal transplant and should be offered to these patients.
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Affiliation(s)
- T Cooke
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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Kamal MM, Soliman SM, Shokeir AA, Abol-Enein H, Ghoneim MA. Bladder carcinoma among live-donor renal transplant recipients: a single-centre experience and a review of the literature. BJU Int 2007; 101:30-5. [PMID: 17850360 DOI: 10.1111/j.1464-410x.2007.07210.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To present our experience with bladder cancer among a renal transplant population and to review critically the relevant literature. PATIENTS AND METHODS In all, 1865 renal graft recipients were followed for a mean (SD) of 6.5 (5) years. Seven recipients (all men) developed a urothelial bladder tumour. The stage and grade of the tumours were determined. The method of the treatment was selected on the basis of the tumour characteristics and graft function. Patients were regularly followed; the endpoints were cancer-specific survival, recurrence or metastasis. RESULTS All patients presented with gross haematuria. There was non-muscle-invasive disease in two patients who were treated by transurethral resection and adjuvant intravesical bacille Calmette-Guérin immunotherapy. One patient died 24 months later due to complications of end-stage renal disease. To date the second patient is alive and free of the recurrence. Five recipients with muscle-invasive disease had a radical cystectomy and orthotopic bladder substitution. The mean (sd) time to the last follow-up or death was 14.6 (3.1) months. Three patients died with stable graft function; two from distant metastasis and one from a cerebrovascular stroke. The remaining two patients are still alive, free of disease and with good graft function. CONCLUSIONS Urothelial bladder tumours are generally uncommon. The presence of haematuria in renal allograft recipients should be thoroughly investigated. Early diagnosis and prompt treatment are required for managing such tumours, because they are aggressive. Orthotopic bladder substitution is feasible with a good functional outcome for patients in whom cystectomy is indicated.
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Affiliation(s)
- Mohamed M Kamal
- Department of Urology, Urology and Nephrology Center, Mansoura, Egypt
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Tseng SF, Chen YT, Cheng YT, Hsieh HH. Method and outcome of transvesical ureterectomy of the distal ureter in nephroureterectomy of native kidney upper tract urothelial carcinoma ipsilateral to a transplanted kidney. Urology 2007; 69:1045-8. [PMID: 17572183 DOI: 10.1016/j.urology.2007.02.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Revised: 01/20/2007] [Accepted: 02/26/2007] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyze outcomes of cases in which we adapted a transvesical ureterectomy technique to remove the distal ureter, including complete removal of the bladder cuff, upon retroperitoneal nephroureterectomy (performed when the diseased native kidney and ureter are ipsilateral to the transplant kidney). METHODS Nineteen cases of upper urinary tract urothelial carcinoma of the native kidney were diagnosed among the 520 kidney transplant recipients at our kidney transplantation clinic over the last 19 years. Of these 19 patients, 11 had urothelial carcinoma of the native kidney ipsilateral to the transplant kidney. Excluding 2 patients in whom different surgical methods were used, we report 9 patients with nephrectomy and kidney removal through a flank incision retroperitoneally, followed by distal ureteral ureterectomy transvesically through a cystotomy incision. RESULTS No postoperative surgical complications were encountered among these 9 immunosuppressed kidney transplant recipients. No perioperative deterioration of transplant kidney function was found. One patient with lower ureteral T2/Tis urothelial carcinoma had a minor ureteral wall tear upon pulling-through of the ureteral hiatus, which was clamped immediately. No retroperitoneum or wound metastasis was found during follow-up, which ranged from 3 months to 11 years and 8 months. CONCLUSIONS This transvesical ureterectomy technique of the distal ureter upon retroperitoneal nephroureterectomy ipsilateral to the transplant kidney is an easy and expeditious approach if the urothelial carcinoma is located in the upper or midureter or renal pelvis.
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Affiliation(s)
- Shu-Fen Tseng
- Department of Urology, Chang Gung Memorial Hospital Kaohsiung, Kaohsiung, Taiwan
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Lang H, de Petriconi R, Wenderoth U, Volkmer BG, Hautmann RE, Gschwend JE. ORTHOTOPIC ILEAL NEOBLADDER RECONSTRUCTION IN PATIENTS WITH BLADDER CANCER FOLLOWING RENAL TRANSPLANTATION. J Urol 2005; 173:881-4. [PMID: 15711303 DOI: 10.1097/01.ju.0000152389.91401.59] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We analyzed the safety and clinical outcome in a single institution experience with orthotopic ileal neobladder reconstruction following radical cystectomy for transitional cell carcinoma in renal transplant recipients. MATERIALS AND METHODS From April 1986 to December 2003 radical cystectomy and orthotopic ileal neobladder reconstruction were performed in 760 consecutive patients with bladder cancer, of whom 4 had bladder cancer a median of 10.5 years after renal transplantation. The postoperative clinical course and long-term results in these patients were reviewed. RESULTS Median followup after surgery was 51.5 months (range 11 to 118). Two patients died at 11 and 15 months of tumor progression and a pulmonary embolism, respectively, whereas 2 were alive at a mean followup of 90 months with no evidence of disease. No neobladder related reoperations were necessary. Serum creatinine as a marker of renal function was stable in 3 patients. In 1 patient chronic graft rejection led to progressive renal failure and hemodialysis. Urinary continence was satisfactory during the day and night with spontaneous voiding in all patients and no significant post-void residual urine. CONCLUSIONS To our knowledge this is the largest reported series of orthotopic ileal neobladder replacement following radical cystectomy in renal transplant recipients. Our results demonstrate the feasibility of radical cystectomy and orthotopic urinary reconstruction in patients with a renal transplant who have good functional and oncological results despite the high comorbidity in this group.
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Affiliation(s)
- Herve Lang
- Department of Urology, University of Ulm, Heidenheim, Germany
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Master VA, Meng MV, Grossfeld GD, Koppie TM, Hirose R, Carroll PR. Treatment and Outcome of Invasive Bladder Cancer in Patients After Renal Transplantation. J Urol 2004; 171:1085-8. [PMID: 14767276 DOI: 10.1097/01.ju.0000110612.42382.0a] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Optimal management and clinical outcome of bladder cancer in renal transplant recipients are not well-defined. We analyzed single institution treatment strategies and outcomes of these patients. MATERIALS AND METHODS We retrospectively reviewed the University of California, San Francisco transplant database which contains information on 6,288 renal transplants performed between 1964 and 2002. The United Network for Organ Sharing database and Israel Penn International Transplant Tumor Registry were also queried to characterize the global nature of bladder cancer in renal transplant recipients. RESULTS The United Network for Organ Sharing database (1986 to 2001) contained information on 31 patients who were found to have bladder cancer (0.024% prevalence) and the Israel Penn International Transplant Tumor Registry (1967 to 2001) contained information on 135 patients representing 0.84% of all reported malignancies. We identified 7 renal transplant recipients with bladder cancer at our institution. Invasive transitional cell carcinoma developed in 5 patients at a median of 2.8 years after transplant. Three patients underwent uncomplicated radical cystectomy and preservation of the renal allograft. Overall survival at 48 months was 60%. CONCLUSIONS Bladder cancer after renal transplantation is not common. For patients who present with invasive disease, traditional extirpative surgery should be considered. Moreover, the allograft is rarely the source of transitional cell carcinoma and can be preserved. In our experience the cancer and urinary outcomes compare favorably with nontransplant patient outcomes after treatment.
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Affiliation(s)
- Viraj A Master
- Departments of Urology and Surgery, University of California, San Francisco, California 94143, USA.
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Selli C, Boggi U, Travaglini F, Vistoli F, Chiaro M, Mosca F. Cystectomy and orthotopic ileal neobladder in a male patient 12 years after kidney transplantation; good preservation of the renal function. Transpl Int 2004. [DOI: 10.1111/j.1432-2277.2004.tb00410.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Affiliation(s)
- M E Sullivan
- Department of Urology, Churchill Hospital, Oxford, UK
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ORTHOTOPIC NEOBLADDER AFTER KIDNEY TRANSPLANTATION IN A MALE PATIENT WITH RECURRING UROTHELIAL CARCINOMA AND RENAL CANCER. J Urol 2001. [DOI: 10.1097/00005392-200110000-00037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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GIESSING MARKUS, TÜRK INGOLF, SCHOENBERGER BERND, LOENING STEFANA. ORTHOTOPIC NEOBLADDER AFTER KIDNEY TRANSPLANTATION IN A MALE PATIENT WITH RECURRING UROTHELIAL CARCINOMA AND RENAL CANCER. J Urol 2001. [DOI: 10.1016/s0022-5347(05)65776-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- MARKUS GIESSING
- From the Department of Urology, Charité University Hospital, Berlin, Germany
| | - INGOLF TÜRK
- From the Department of Urology, Charité University Hospital, Berlin, Germany
| | - BERND SCHOENBERGER
- From the Department of Urology, Charité University Hospital, Berlin, Germany
| | - STEFAN A. LOENING
- From the Department of Urology, Charité University Hospital, Berlin, Germany
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Garimaldi Pérez S, Fariña Pérez LA, Cabezas Checci CA, Antón Badiola I, Zungri Teló ER. [Diffuse involvement and rapid progression of high-grade transitional carcinoma in a kidney transplant recipient]. Actas Urol Esp 2000; 24:179-81. [PMID: 10829450 DOI: 10.1016/s0210-4806(00)72426-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In renal transplant patients, an increased risk of cancer has been seen, higher than in the general population, and the more frequent genitourinary neoplasms are the kidney and bladder ones. Moreover, in those patients the pattern of tumor growth is very rapid, with early tendency to local and systemic dissemination. The case here presented, a patient with kidney transplant 3 years before, with high grade, superficial transitional cell carcinoma involving the whole bladder, the pelvis and the ureter of the right native kidney, shown this fast progression. Four months after radical cystectomy plus bilateral nephroureterectomy, the disease progressed to intraperitoneal and hepatic metastases.
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