ArticleInternational urology and nephrology2026
De novo urothelial carcinoma in kidney transplant recipients: a single-center retrospective cohort study.
Article in International urology and nephrology, 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
purposeTo characterize the incidence, clinicopathologic features, treatment patterns, and both oncologic and graft-related outcomes of de novo urothelial carcinoma (UC) in kidney transplant recipients (KTRs) at a large German transplant center.
methodsRetrospective single-center cohort of KTRs (2005-2024). 19 patients with post-transplant UC were identified among 4,012 KTRs. We extracted demographics, transplant and tumor characteristics, treatments, graft outcomes, and survival. The standardized incidence ratio (SIR) was calculated using population-based incidence rates, and Kaplan-Meier estimates were used for overall survival (OS), metastasis-free survival (MFS), and graft survival (GS).
resultsUC occurred in 0.47% of KTRs, yielding an SIR of 2.21 (95% confidence interval [CI] 1.33-3.44) compared with the general population. Most tumors were bladder-based (63.2%), but there was a high proportion of upper-tract urothelial carcinoma (UTUC; 31.6%), including graft-involving tumors. Radical surgery was performed in 47.4% of patients, 15.8% received systemic chemotherapy, and intra-vesical therapy was rarely used. Median OS after UC diagnosis was 55 months, with estimated 3- and 5-year OS rates of 70% and 51%, respectively, and 3- and 5-year MFS rates of 73%. Graft failure occurred in 47.4% of patients, and in 21.1% of the total cohort it was directly attributed to UC.
conclusionPost-transplant UC in KTRs is associated with a more than twofold increased incidence compared with the general population and a disproportionate burden of upper tract and graft-involving tumors. Management must carefully balance oncologic control against preservation of transplant function in a setting where standard intra-vesical and systemic therapies are constrained by immunosuppression. These findings support risk-adapted lifelong urologic surveillance and highlight the need for dedicated treatment strategies tailored to immunosuppressed patients.
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