2313 PARENCHYMATOUS DE NOVO RENAL GRAFT TUMOR. MULTICENTER DESCRIPTIVE NATIONAL STUDY WITH 25585 RENAL TRANSPLANTS
2013; Lippincott Williams & Wilkins; Volume: 189; Issue: 4S Linguagem: Inglês
10.1016/j.juro.2013.02.2254
ISSN1527-3792
AutoresFrancisco Gómez Veiga, J.L. Ponce Díaz-Reixa, Enrique Lledó, Jesús Blázquez, Alberto Breda, Paola Pardo, Mireía Musquera, Antonio Alcaraz, J Garcia-Olaverri Rodríguez, Carlos Pertusa Peña, Francisco Burgos, Carlos Sánchez García, Luis Riera Canals, José Manuel Cózar, A. Rodrı́guez-Antolı́n, Alfredo Aguilera Bazán, Pedro Gutiérrez,
Tópico(s)Organ Donation and Transplantation
ResumoYou have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Renal Vascular Surgery (II)1 Apr 20132313 PARENCHYMATOUS DE NOVO RENAL GRAFT TUMOR. MULTICENTER DESCRIPTIVE NATIONAL STUDY WITH 25585 RENAL TRANSPLANTS Francisco Gomez Veiga, Jose Ponce Díaz-Reixa, Enrique Lledó, Jesus Blazquez, Alberto Breda, Paola Pardo, Mireia Musquera, Antonio Alcaraz, J Garcia-Olaverri Rodríguez, Carlos Pertusa Peña, Francisco Burgos, C García, Luis Riera Canals, Jose Manuel Cózar, Alfredo Rodríguez Antolín, Alfredo Aguilera, and Pedro Gutierrez Francisco Gomez VeigaFrancisco Gomez Veiga A Coruña, Spain More articles by this author , Jose Ponce Díaz-ReixaJose Ponce Díaz-Reixa A Coruña, Spain More articles by this author , Enrique LledóEnrique Lledó Madrid, Spain More articles by this author , Jesus BlazquezJesus Blazquez Madrid, Spain More articles by this author , Alberto BredaAlberto Breda Barcelona, Spain More articles by this author , Paola PardoPaola Pardo Barcelona, Spain More articles by this author , Mireia MusqueraMireia Musquera Barcelona, Spain More articles by this author , Antonio AlcarazAntonio Alcaraz Barcelona, Spain More articles by this author , J Garcia-Olaverri RodríguezJ Garcia-Olaverri Rodríguez Bilbao, Spain More articles by this author , Carlos Pertusa PeñaCarlos Pertusa Peña Bilbao, Spain More articles by this author , Francisco BurgosFrancisco Burgos Madrid, Spain More articles by this author , C GarcíaC García Sevilla, Spain More articles by this author , Luis Riera CanalsLuis Riera Canals Barcelona, Spain More articles by this author , Jose Manuel CózarJose Manuel Cózar Sevilla, Spain More articles by this author , Alfredo Rodríguez AntolínAlfredo Rodríguez Antolín Madrid, Spain More articles by this author , Alfredo AguileraAlfredo Aguilera Madrid, Spain More articles by this author , and Pedro GutierrezPedro Gutierrez Tenerife, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2254AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES On transplanted population, neoplasm incidence is higher than non-transplanted population, considering actually as a solid organ complication. Renal cell carcinoma incidence on transplanted population is 4.6%, affecting less than 10% to renal graft. The challenge on this situation will be to preserve renal function without oncological risks. The aim of this study is to analyze a multicenter national series, to know functional and oncological outcomes. METHODS 41 cases of de novo parenchymal renal graft tumors were analyzed on a retrospective, descriptive multicenter national study with 25585 renal grafts. Medium receptor age at transplantation was 46.3 y.o. Time on dialysis prior to transplantation was 53.3m. Medium cold ischemia time was 603.6m. Transplantation-tumor diagnosis delay was 137.9m. Most cases (85%) were solitary incidentally tumors. Medium clinical tumor size was 26.5mm(5-50). Diagnosis was made by ultrasound (75,6%) and confirmed by CT scan (82%), mostly with a solid mass appearance (77%). 23% of cases were biopsied percutaneously. RESULTS Frequency results are described on table 1. 12% of cases had complications and medium hospital stay was 10.6 days. Renal function was not altered. Pathologic date showed 94% of carcinoma with clear cell and papillary histologic pattern on 26% and 41%, respectively. Nuclear grade was Fuhrman II on 46.3%. Pathologic medium size was 25.7mm. All surgical margins were negative. One patient (3%) had local progression after tumorectomy after 35.4 months. Medium follow up is 37.5m. 65.9% has functionally renal graft, con medium creatinine levels of 1.74 mg/dl. Causes of graft loss (34.1%) were chronic rejection (22%), tumor treatment (67%) and tumor recurrence (11%). 62% of patients are alive on follow up. CONCLUSIONS This study let us suggest that nephron sparing surgery on de novo tumors on renal graft is a safe procedure, with low morbi-mortality and low hospitalization, in patients with functionally renal grafts. Medium-term functional and oncological data support this attitude. Table 1. Results Graft function n % No 4 9.8 % Yes 36 87.8 % Missing 1 2.4 % Type of treatment n % Surgery 38 92.7 % Radiofrequency 2 4.9 % Cryotherapy 1 2.4 % Type of surgery (n=38) n % Non nephron sparing surgery (Non NSS) 11 26.8 % Nephron sparing surgery (NSS) 27 65.9 % Type of NSS (n=27) n % Tumorectomy 18 43.9 % Partial Nephrectomy 9 22.0 % Type of approach (n) n % Open surgery 34 82.9 % Laparoscopic 4 9.8 % Percutaneous 3 7.3 % Pathologic stage (pT) n % pT1 30 73.2 % pT1b 2 4.9 % pT2 2 4.9 % Missing 4 9.8 % Surgical margins (NSS) n % Negative 27 100 % Tumor progression n % Local 2 4.9 % Regional 0 0 % Systemic 1 2.4 % Graft function on follow up n % No 14 34.1 % Yes 27 65.9 % Survival n % Exitus 5 12.2 % Alive 29 70.7 % Lost to follow up 7 17.1 % © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e948-e949 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francisco Gomez Veiga A Coruña, Spain More articles by this author Jose Ponce Díaz-Reixa A Coruña, Spain More articles by this author Enrique Lledó Madrid, Spain More articles by this author Jesus Blazquez Madrid, Spain More articles by this author Alberto Breda Barcelona, Spain More articles by this author Paola Pardo Barcelona, Spain More articles by this author Mireia Musquera Barcelona, Spain More articles by this author Antonio Alcaraz Barcelona, Spain More articles by this author J Garcia-Olaverri Rodríguez Bilbao, Spain More articles by this author Carlos Pertusa Peña Bilbao, Spain More articles by this author Francisco Burgos Madrid, Spain More articles by this author C García Sevilla, Spain More articles by this author Luis Riera Canals Barcelona, Spain More articles by this author Jose Manuel Cózar Sevilla, Spain More articles by this author Alfredo Rodríguez Antolín Madrid, Spain More articles by this author Alfredo Aguilera Madrid, Spain More articles by this author Pedro Gutierrez Tenerife, Spain More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...
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