Single Center Clinical Experience Summary Of Malignant Tumor After Renal Transplantation

Objective:This study retrospectively analyzed the clinical data of patients with malignant tumor after kidney transplantation in Xijing Hospital,combined with relevant literatures at home and abroad,explored the pathogenesis characteristics of malignant tumor after kidney transplantation,analyzed the prognosis,and provided reference for its prevention and treatment.Method:A total of 982 patients who received allograft kidney transplantation in urology Department of Xijing Hospital from October 2008 to October 2021 and were thoroughly followed up were selected.After screening according to the relevant inclusion and exclusion criteria of this study,a total of 32 eligible cases of malignant tumor after kidney transplantation were selected.The basic information,kidney transplantation related information,malignant tumor related information,treatment and prognosis were analyzed statistically.Measurement data were expressed using(X 12 ±s)and median,independent sample T test,and counting data were expressed using frequency and percentage,and Chi-square test.Kaplan-meier method was used for survival analysis of some factors,and log-rank test was used for univariate analysis.Results:Of the 982 renal transplant recipients,32 were diagnosed as new malignancies,with an overall incidence of 3.26%.There were 21 males(3.42%)and 11 females(2.99%).Among the 32 patients with malignant tumor after renal transplantation,1 had a history of malignant tumor and 2 had a family history of malignant tumor.Chronic glomerulonephritis was the most common primary disease before renal transplantation(53.2%).The longest preoperative dialysis time was 108 months,the shortest was 1 month,and the median was 14 months.The maximum age of kidney transplantation was 68 years,the minimum age was 22 years,the mean age at transplantation was 45.4±11.6 years,and the median age at transplantation was 45.5 years.At the time of discovery of malignant tumor,the maximum age was 69 years,the minimum age was 34 years,the mean age was 51.6±10.4 years,and the median age was 52 years.The maximum time to diagnosis of malignancy was 208 months,the minimum was 15 months,and the median was 54.5 months.Among the new malignancies,urinary and male reproductive system tumors were the most common,accounting for 50%,followed by digestive system tumors,accounting for 21.9%.The most common organ was the original kidney,accounting for 28.1%.Among all the clinical stages of malignant tumors,13 cases were stage i,9 cases were stage ii,7 cases were stage ⅲ,and 3 cases were stage ⅳ.Twenty-seven patients were treated with surgery,one with radiotherapy,one with chemotherapy,and three with no treatment.There was progression of 10 malignant tumors.Twelve patients died and 20 survived,with an overall mortality of 37.5%.Male mortality rate was 38.1%,female mortality rate was 36.4%,there was no significant difference between the two groups(P=0.925).The 1-year cumulative survival rate was 90.3%,and the 5-year cumulative survival rate was 50.7%.Among the 12 deaths,the minimum survival time was 10 months and the maximum survival time was 114 months from the time of tumor discovery.The minimum survival time was 12 months and the longest survival time was 110 months.The two groups were divided into two groups according to survival,and there were statistically significant differences in clinical stage,surgery and donor kidney source between the two groups.Survival analysis of all malignant tumors showed that clinical stage,whether surgery was performed and the source of donor kidney were the influencing factors for survival of malignant tumor patients after renal transplantation.Conclusions:In this study,urinary system and male reproductive system had the highest incidence of malignant tumors;Among all sites,the highest incidence is in the protokidney.Clinical stage of malignant tumor and whether to receive surgery were different between surviving patients and dying patients.Whether to receive surgery,clinical stage of malignant tumor and source of donor kidney were the factors affecting their survival.