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Incidence and long‐term outcomes of squamous cell bladder cancer after deceased donor renal transplantation
Author(s) -
Davis N. F.,
McLoughlin L. C.,
Dowling C.,
Power R.,
Mohan P.,
Hickey D.,
Smyth G.,
Eng M.,
Little D. M.
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12245
Subject(s) - medicine , surgery , transplantation , bladder cancer , cystectomy , incidence (geometry) , kidney transplantation , cohort , tacrolimus , urology , cancer , optics , physics
Objective To review the incidence and long‐term outcomes of squamous cell carcinoma ( SCC ) of the bladder in patients after kidney transplantation. Methods Between January 1976 and March 2013, five patients from one center (0.0013%) developed SCC of the bladder after undergoing a deceased donor kidney transplant. Their relevant risk factors included long‐term self‐intermittent catheterization/indwelling catheter (n = 2), smoking history (n = 2), and a prior history of cyclophosphamide treatment for vasculitis (n = 1). Primary outcome variables were overall patient survival and latency period between transplantation and SCC diagnosis. Results The duration of long‐term follow‐up was 94 ± 89 (range: 4–239) months. The latency period between transplantation and bladder SCC was 87 ± 87 (range: 2–228) months, and all five patients were immunosuppressed with tacrolimus, mycophenolate mofetil, and prednisone. Four patients had suspected metastases upon presentation, and one patient presented with organ‐confined disease. This patient underwent a radical cystectomy and remains disease free eight months post‐operatively. Despite radical treatment, the remaining four patients died from metastatic disease 7 ± 4.4 (range: 2–11) months after their initial diagnosis. Conclusion SCC of the bladder has a poor prognosis particularly in renal transplant patients. Early detection with flexible cystourethroscopy in patients with risk factors for SCC may improve long‐term outcomes in this patient cohort.