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Duong NX, Le MK, Nguyen TT, Nguyen DD, Vuong HG, Kondo T, Mitsui T. Acquired Cystic Disease-Associated Renal Cell Carcinoma: A Systematic Review and Meta-analysis. Clin Genitourin Cancer 2024; 22:102050. [PMID: 38502982 DOI: 10.1016/j.clgc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 03/21/2024]
Abstract
Acquired cystic disease-associated renal cell carcinoma (ACD-RCC) is a common subtype of renal cell carcinoma (RCC) in end-stage renal disease (ESRD) patients. The current systematic review and meta-analysis was performed to evaluate the clinicopathological, and genetic characteristics of patients with ACD-RCC. A systematic search on three electronic databases including the Pubmed, Scopus, and Web of Science databases were performed until December 31, 2022. A meta-analysis was performed following the PRISMA 2020 Guidelines. Of 888 identified articles, full-text screening in 69 articles, there were 26 articles analyzed, with a total of 2314 tumors in 2199 patients, including 418 ACD-RCC tumors in 363 patients, 1340 clear cell RCC (ccRCC) tumors, 308 papillary RCC (pRCC) tumors. Most ACD-RCC patients were male (80.2%). All the ACD-RCC patients underwent prior dialysis with 148.2 months of mean dialysis duration. There were 8.7%, 3.4%, and 5.8% tumors at the T3-4 stage, N1 stage, and M1 stage, respectively. The mean overall survival of ACD-RCC patients was 39.6 months (95% CI, 26.6-52.5). Compared to ccRCC and pRCC, ACD-RCC patients had a longer duration of dialysis (MD: 103.5 and 31.77 months, respectively; 95% CI: [75.48; 131.53] and [0.95; 62.58], respectively), and a higher rate of multifocal tumors (MD: 3.46 and 2.45 tumors, respectively; 95% CI [1.71; 6.98] and [1.26; 4.79], respectively). Regarding genetic characteristics, chromosomes 3 and 16 were the 2 most frequent chromosomal aberrations. The missense mutation in KMT2C (25%) and TSC2 (18.75%) were the 2 most common gene mutations in ACD-RCC. In conclusion, the ACD-RCC subtype exhibited several distinct clinicopathological and genetic characteristics compared to others RCC subtypes. Further researchs are needed to assess the survival outcome and the genetic characteristics of this subtype.
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Affiliation(s)
- Nguyen Xuong Duong
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo-city, Japan; Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
| | - Minh-Khang Le
- Department of Pathology, University of Yamanashi Graduate School of Medical Sciences, Chuo-city, Japan
| | - Tuan Thanh Nguyen
- Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Vietnam; Department of Urology, University of Medicine and Pharmacy at Ho Chi Minh city, Vietnam
| | - Duy Duc Nguyen
- Department of Pathology, University Medical Center of HCMC, Ho Chi Minh City, Vietnam
| | - Huy Gia Vuong
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi Graduate School of Medical Sciences, Chuo-city, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo-city, Japan
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Minkovich M, Wong RBK, Famure O, Li Y, Kim SJ, Lee JY. Renal cell carcinoma in kidney transplant recipients: incidence, trends, clinical management & outcomes. World J Urol 2023; 41:2389-2395. [PMID: 37450008 DOI: 10.1007/s00345-023-04495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE To describe the incidence, characteristics, clinical management, and outcomes of renal cell carcinoma (RCC) among a large, single-centre cohort of kidney transplant recipients (KTR). METHODS We conducted an observational cohort study looking at KTR transplanted between January 2000-December 2017 (n = 2443) with ≥ 1 year of follow-up. Simultaneous kidney/pancreas transplants were excluded. The Kaplan-Meier product-limit method was used to determine the incidence of RCC. Characteristics and management of RCC were examined using descriptive statistics. Risk factors and clinical outcomes were analyzed using Cox regression models. RESULTS The incidence of RCC among our cohort was 0.32 per 100 person-years, 2.1% of all KTRs. Almost half (47.1%) of cases occurred within 4 years post-transplant. The majority of cases were T1a (86.3%), clear-cell (45.1%), and in the native kidney (80.4%). KTR diagnosed with RCC had a twofold higher incidence of other malignancies versus KTR without RCC. Overall mortality, but not cancer-specific mortality, at 2- and 5-years post-transplant was threefold higher among KTR with RCC than those without. CONCLUSIONS Incidence of RCC among our KTR was slightly higher than the general population; majority of cases occur in the native kidneys and are low stage, low grade. Indolent histologic variants were more common than the general population. KTR with RCC had a higher incidence of other malignancies. Overall, but not cancer-specific, mortality was higher among KTRs diagnosed with RCC.
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Affiliation(s)
- Michelle Minkovich
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada
| | - Rebecca Bic Kay Wong
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada
| | - Olusegun Famure
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada
| | - Yanhong Li
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada
| | - S Joseph Kim
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada
- Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Jason Y Lee
- Ajmera Transplant Centre, Toronto General Hospital, University Health Network, 585 University Avenue, 11-PMB-186, Toronto, ON, M5G 2N2, Canada.
- Department of Surgery, Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada.
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Silva RM, Leal R, Marques MG, Rodrigues L, Santos L, Romãozinho C, Alves R, Figueiredo A. Renal Transplantation in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Single-Center 10-Year Experience. Transplant Proc 2023; 55:1396-1399. [PMID: 37202303 DOI: 10.1016/j.transproceed.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a common cause of rapidly progressive glomerulonephritis resulting in end-stage renal disease. The optimal timing of kidney transplantation for end-stage renal disease due to AAV and the risk of relapse after kidney are poorly defined. Our study aimed to evaluate the clinical outcomes of AAV after kidney transplantation, namely the risk of relapse, rejection, and oncologic disease. METHODS This retrospective study included all patients with AAV submitted to a kidney transplant between January 2011 and December 2020. RESULTS Twenty-seven patients (20 males/7 females; mean age 47 years) received a kidney transplant for end-stage renal disease secondary to microscopic polyangiitis (n = 25) or granulomatosis with polyangiitis (n = 2). All patients were in clinical remission at the time of the kidney transplant, but 11 patients were ANCA-positive. A vasculitis relapse after kidney transplantation occurred in only 1 patient (3.7%). Rejection episodes, proven by allograft biopsy, were present in 3 patients (11.1%), with graft losses in 2 (66.7%). The median time until the graft was lost after the initial rejection diagnosis was 27 ± 8 months. Oncologic complications were present in 9 patients (33.3%). Five patients died (18.5%), and the main cause of death was cardiovascular disease (n = 3, 60.0%), followed by oncologic disease (n = 2, 40.0%). CONCLUSIONS Kidney transplantation is a safe and effective option for treating end-stage renal disease secondary to AAV. Current immunosuppression regimens make relapses and rejection infrequent but place oncologic complications at a higher incidence.
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Affiliation(s)
- Rita M Silva
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal.
| | - Rita Leal
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maria G Marques
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Luís Rodrigues
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Lídia Santos
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Catarina Romãozinho
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui Alves
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Nephrology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Arnaldo Figueiredo
- Department of Nephrology, Urology, and Kidney Transplantation, Coimbra University Hospital Center, Coimbra, Portugal; Urology University Clinic, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Outcome of Patients With Small Vessel Vasculitis After Renal Transplantation: National Database Analysis. Transplant Direct 2018; 4:e350. [PMID: 29707620 PMCID: PMC5912015 DOI: 10.1097/txd.0000000000000769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/22/2018] [Indexed: 12/01/2022] Open
Abstract
Background Small vessel vasculitis commonly affects the kidney and can progress to end-stage renal disease. The goal of this study is to compare outcomes of patients who received a renal transplant as a result of small vessel vasculitis (group A) with those who received kidney transplants because of other causes (group B). Methods This is a retrospective analysis of United Network for Organ Sharing registry data for adult primary kidney transplants from January 2000 to December 2014. Group A patients (N = 2196) were compared with a group B (N = 6588); groups were case matched for age, race, sex, donor type, and year of transplant in a 1:3 ratio. Results Renal and patient survivals were better in the group A (P < 0.001). New-onset diabetes after transplant developed in 8.3% of the group A and 11.3% of group B (P < 0.001). Seventeen (0.8%) patients in group A developed recurrent disease. Of these, 7 patients had graft failure, 3 of which were due to disease recurrence. Group A patients had significantly higher risk of developing posttransplant solid organ malignancies (11.3% vs 9.3%, P = 0.006) and lymphoproliferative disorder (1.3% vs 0.8%, P = 0.026). Independent predictors of graft failure and patient mortality were recipients' morbid obesity, diabetes, age, and dialysis duration (hazard ratio of 1.7, 1.4, 1.1/10 years, and 1.1/year for graft failure, and 1.7, 1.7, 1.6/10 years and 1.1/year for patient mortality, respectively). Conclusions Renal transplantation in patients with has favorable long-term graft and patient outcomes with a low disease recurrence rate. However, they may have a higher risk of developing posttransplant malignancies.
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Billis A, Freitas L, Costa L, Barreto I, Asato M, Araujo K, Losada D, Herculiani A, Tabosa G, Zaidan B, Oliveira G, Bastos L, Rocha R. Genitourinary Malignancies in Transplant or Dialysis Patients: The Frequency of Two Newly Described 2016 World Health Organization Histopathologic Types. Transplant Proc 2017; 49:1783-1785. [DOI: 10.1016/j.transproceed.2017.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 05/18/2017] [Accepted: 06/01/2017] [Indexed: 11/27/2022]
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Minnee RC, Kimenai HJAN, Verhagen PC, von der Thüsen JH, Dwarkasing RS, van de Wetering J, IJzermans JN. Algorithm for Bosniak 2F Cyst in Kidney Donation. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:733-738. [PMID: 28663537 PMCID: PMC5503233 DOI: 10.12659/ajcr.904045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Patient: Female, 54 Final Diagnosis: Multilocular cystic renal cell carcinoma with clear cells Symptoms: None Medication: — Clinical Procedure: Hand-assisted retroperitoneal donor nephrectomy Specialty: Transplantology
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Affiliation(s)
- Robert C Minnee
- Department of Surgery, Division of Hepato-Pancreato-Biliary and Transplant Surgery, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Hendrikus J A N Kimenai
- Department of Surgery, Division of HPB and Transplant Surgery, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Paul C Verhagen
- Department of Urology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jan H von der Thüsen
- Department of Pathology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Roy S Dwarkasing
- Department of Radiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jacqueline van de Wetering
- Department of Nephrology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jan N IJzermans
- Department of Surgery, Division of Hepato-Pancreato-Biliary and Transplant Surgery, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
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