ArticleWorld journal of urology2026
Incidence and outcomes of malignancies in renal transplant recipients: a 57-year single-center experience.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionKidney transplant recipients (KTRs) have a markedly increased risk of malignancy due to chronic immunosuppression and oncogenic exposures. This study describes the spectrum, management, and outcomes of post-transplant malignancies over nearly six decades at a tertiary center.
methodsWe conducted a retrospective study of adult KTRs at the National Institute of Nutrition (1967–2024). Patients with post-transplant malignancy and complete clinical records were included. Demographic data, immunosuppressive regimens, tumor characteristics, treatment, and survival were analyzed. Tumor-level and patient-level denominators were reported separately.
resultsAmong 1,419 KTRs, 116 developed cancer and 98 had complete records, accounting for 136 malignancies. Per tumor, non-melanoma skin cancer represented 41% (56/136), genitourinary (GU) cancers 27% (37/136), and lymphomas 12% (16/136). At the patient level, 61% were male and 51% were older than 50 years at diagnosis. Three EBV-positive post-transplant lymphoproliferative disorders were identified. Most tumors were localized (86%) and surgically treated (84%). Median overall survival after cancer diagnosis was 19.0 years (1-, 3-, and 5-year survival: 0.90, 0.84, and 0.82), while cancer-specific and disease-free survival did not reach median (5-year: 0.96 and 0.88). On multivariable analysis, mycophenolate mofetil (MMF) use was independently associated with a GU malignancy phenotype (OR 4.79; 95% CI 1.11–20.70). Age > 50 years was associated with worse overall survival on log-rank testing.
conclusionsIn this long-term cohort, non-melanoma skin and GU cancers were the most common post-transplant malignancies. Most tumors were detected at localized stages, yet older age and immunosuppressive exposure influenced cancer phenotype and prognosis. EBV-related PTLD was documented. These findings support tailored oncologic surveillance —emphasizing dermatologic evaluation, renal imaging of native and graft kidneys, risk-adapted PSA testing— and careful immunosuppression modulation.
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