Login to Access Video or Poster Abstract: MP06-17
Sources of Funding: None

Introduction

Cancer development after KT is increasing, and urothelial carcinoma (UCa) incidence has been estimated 3 times higher, especially focused in bladder. However, upper urinary tract (UUT) can also be affected, both in native and less commonly in graft UUT. Management of UCa after KT is demanding because of aggressiveness and potential graft involvement. The aim of the study is to assess all UCa developed after KT, as well as treatments performed and oncological outcomes

Methods

Retrospective analysis of 1.693 KT at our institution between 1977-October 2016. Age, sex, tumor location, TNM stage, tumor grade, presence of Cis, treatments and oncological outcomes are assessed, including median Overall Survival (mOS) and cancer-specific-survival (CSS)

Results

13 patients developed 14 UCa (0.83%), 61.5% male. Median age at the moment of cancer was 62.5 years (range 40-81) and median time from KT to cancer 52.5 months (range 2-209). UCa were located in bladder (8), in native UUT (1) and in graft UUT (5). At diagnosis, only 1 patient was metastatic and 35% of the cases (5/14) had Cis associated. Regarding tumor grade, 1 was G2, 9 were G3 and 4 were G4. Pathologic stage and treatments performed for UCa after KT are detailed in Table 1. 67% patients with non-muscle-invasive bladder tumor (NMIBT) received BCG. All patients with graft UUT UCa had locally advanced tumors and were treated with graft RNU and pelvic lymphadenectomy, returning to dialysis. At present, 69.2% (9/13) are alive, and median-overall-survival (mOS) is 36 months (range 2-182). Of the total 4 deaths, 1 was cancer-related, 1 during RC postoperative course and the other 2 ESRD-related. Cancer-specific-survival (CSS) was 92% (12/13). _x000D_

Conclusions

Bladder is the most common place of UCa after KT. BCG is also a part of the treatment in these patients. Graft UUT UCa was relatively high in our study comparing to literature. It is usually locally advanced and sometimes unresectable. mOS of UCa after KT is 36 months, which is lower than other uro-cancers in this population. Treatment of this cancer is challenging and can potentially involve the graft, being necessary to remove it and so returning to dialysis

Funding

None