Risk of Second Solid Malignancy among 1000 Kidney Transplanted Patients: A Single Center Study

Michele L. Santangelo, Sergio Spiezia, Nicola Carlomagno, Concetta Dodaro, Cristina La Tessa, Davide De Rosa, Maria Pina Piantadosi, Andrea Renda

Department of Surgery, Anesthesia and Emergency Science, School of Medicine – University of Naples “Federico II”, Naples, Italy.

DOI: 10.4236/ojots.2012.24011                

Abstract

In this study we focus on kidney-transplanted patients in order to investigate the correlation between immunodeficiency (ID) induced by immunosuppressive treatments and the incidence of solid multiple primary malignancies (MPM). Material of study: From 1980 to 2010 we followed up 1000 kidney-transplanted patients (637M, 363F). This group was homogeneous for age, immunology (e.g. miss-match index), number of rejection events and for immunosuppressive therapy. Results: Out of 1000 kidney-transplanted patients we observed 70 patients (53M, 17F) with cancer disease and in 22 of them a multiple cancer has been found. Most of multiple cancer were synchronous and the association between cancer and rejection episodes were not significant. Discussion: In general population 1 out of 9 patients with a cancer would develop a second neoplasia during the course of his life, so, it would be logical to conclude that, from a merely theoretical and statistical point of view, long term transplanted patients potentially have a higher risk to develop MPM. But our series and literature review did not confirm it, probably because these patients die before the appearance of a second primary malignancy. Conclusions: Despite many observations regarding different types of tumors/pre-cancerous lesions and their increased incidence in ID patients and despite the fact that immune suppression is a predisposing factor for the multicancer syndrome, at least theoretically, nowadays there are no significant statistical data favouring a correlation between ID and MPM in kidney transplanted patients.

Keywords

Multiple Primary Malignancies; Immunosuppressive Therapy; Kidney Transplantation

Conflicts of Interest

The authors declare no conflicts of interest.

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