Significant Risk Factors for Occurrence of Cancer After Renal Transplantation: A Single Center Cohort Study of 1265 Cases
Significant Risk Factors for Occurrence of Cancer After Renal Transplantation: A Single Center Cohort Study of 1265 Cases
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DOI：
10.1016/j.transproceed.2008.12.013
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发表时间：
2009-03-01
影响因子：
0.9
通讯作者：
Berthoux, F.
中科院分区：
文献类型：
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作者：
Bichari, W.;Bartiromo, M.;Berthoux, F.
肾移植术后癌症的发生是一个主要问题，也是第二大死亡原因。我们对1979年至2006年的1265例首次癌症、首次皮肤癌和首次器官癌（包括移植后淋巴组织增生性疾病[PTLD]）进行了回顾性分析。癌症的发生明显是一个时间依赖性事件，证实了Kaplan-Meier生存率和考克斯回归方法的使用。首次癌症、首次皮肤癌和首次器官癌的10年累积发病率分别为24.6%、14.5%和14.5%。年龄是3个终点的主要独立危险因素，相对危险度每年增加6%（P <0.0001）。女性也是一个主要的独立风险因素，但仅限于皮肤癌（P = .0002）。我们不能证明用于诱导或维持治疗的免疫抑制药物之间的任何差异，尤其是抗胸腺细胞球蛋白（ATG）与抗CD 25，环孢素与他克莫司，硫唑嘌呤与霉酚酸酯之间的差异。需要对接受者年龄和性别进行严格分层的大型队列，以检测药物之间的任何差异（如果有的话）。
Occurrence of cancer after renal transplantation remains a major problem, and the second cause of death. We performed a retrospective analysis of first cancer, first skin cancer, and first organ cancer (including posttransplant lymphoproliferative disease [PTLD]) among 1265 cases from 1979 to 2006. The occurrence of cancer was clearly a time-dependent event justifiying the use of Kaplan-Meier survival and Cox regression methods. The 10-year cumulative incidences of first cancer, first skin cancer, and first organ cancer were 24.6%, 14.5%, and 14.5%, respectively. Recipient age was a major, independent risk factor for the 3 endpoints with 6% increased relative risk for each year increment (P < .0001). Female gender was also a major, independent risk factor, but only for skin cancer (P = .0002). We Could not demonstrate any difference between the immunosuppressive drugs used for induction or maintenance therapy, especially between antithymocyte globulin (ATG) vs anti-CD25, cyclosporine vs tacrolimus, and azathioprine vs mycophenolate mofetil. Large cohorts are needed with strict stratifications for recipient age and gender to detect any difference, if any, among the drugs.