Breast cancer after kidney transplantation: a single institution review

World Journal of Surgical Oncology

Byung-Joo Song¹  Sang-Seol Jung¹  Ja-Seong Bae¹  Byung-Joo Chae¹  Hee-Yong Kwak¹ 

[1] Department of Surgery, Catholic University of Korea, College of Medicine, Seoul, Republic of Korea

关键词: Transplants;    Prognosis;    Breast cancer;   

Others  :  825759
DOI  :  10.1186/1477-7819-11-77

 received in 2012-12-14, accepted in 2013-03-10,  发布年份 2013

【 摘 要 】

Background

Improvements in immunosuppression have resulted in long life expectancy of kidney transplants. Unfortunately, the incidence of post-transplant malignancy (PTM) is increasing. The aim of this study was to evaluate the nature and stage-specific prognosis of post-transplant breast cancer (PTBC) compared with breast cancer in the general population, and to suggest optimal treatment strategies.

Methods

A database of 2,139 consecutive kidney transplant patients was reviewed;11 of the patients developed breast cancer. These 11 PTBC cases underwent operations between 1999 and 2011. Next, 2,554 breast cancer patients treated in the same period were reviewed. Kaplan–Meier curves and the log-rank test were used to assess stage-specific survival of breast cancer in our hospital.

Results

In total, 142 cases experienced post-transplant malignancy (PTM; 6.6%) and 11 (0.5%) developed PTBC. No one required an adjusted dose of immunosuppressive agent. Two stage III patients died. For all breast cancer patients, 5-year survival by stage was 97.7% for stage I, 92.9% for stage II, 78.6% for stage III, and 49.9% for stage IV. The 5-year survival for expected stage III-specific survival was 66.7% and no significant statistical difference was seen compared to that of the total breast cancer patients (P = 0.213).

Conclusions

The prognosis of PTBC was comparable to that of the general population. These results suggest that the use of immunosuppressants per se does not adversely affect breast cancer.

【 授权许可】

   
2013 Kwak et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Catena F, Nardo B, Livianod’Arcangelo G, Stefoni S, Arpesella G, Faenza A, Cavallari A: De novo malignancies after organ transplantation. Transplant Proc 2001, 33:1858-1859.
• [2]Winkelhorst JT, Brokelman WJ, Tiggeler RG, Wobbes T: Incidence and clinical course of de-novo malignancies in renal allograft recipients. Eur J SurgOncol 2001, 27:409-413.
• [3]London NJ, Farmery SM, Will EJ, Davison AM, Lodge JP: Risk of neoplasia in renal transplant patients. Lancet 1995, 346:403-406.
• [4]Marcen R, Galeano C, Fernandez-Rodriguez A, Jimenez-Alvaro S, Teruel JL, Rivera M, Burgos FJ, Quereda C: Effects of the new immunosuppressive agents on the occurrence of malignancies after renal transplantation. Transplant Proc 2010, 42:3055-3057.
• [5]Popov Z, Ivanovski O, Kolevski P, Stankov O, Petrovski D, Cakalaroski K, Ivanovski N: De novo malignancies after renal transplantation–a single-center experience in the Balkans. Transplant Proc 2007, 39:2589-2591.
• [6]Pedotti P, Cardillo M, Rossini G, Arcuri V, Boschiero L, Caldara R, Cannella G, Dissegna D, Gotti E, Marchini F: Incidence of cancer after kidney transplant: results from the North Italy transplant program. Transplantation 2003, 76:1448-1451.
• [7]Stratta P, Morellini V, Musetti C, Turello E, Palmieri D, Lazzarich E, Cena T, Magnani C: Malignancy after kidney transplantation: results of 400 patients from a single center. Clin Transplant 2008, 22:424-427.
• [8]Vachtova M, Treska V, Suvova B, Hes O, Ebelenderova D: Breast carcinoma in a female patient after kidney transplantation–a case review. RozhlChir 2009, 88:687-690.
• [9]Veroux M, Puliatti C, Fiamingo P, Cappello D, Macarone M, Puliatti D, Vizcarra D, Gagliano M, Veroux P: Early de novo malignancies after kidney transplantation. Transplant Proc 2004, 36:718-720.
• [10]Self M, Dunn E, Cox J, Brinker K: Managing breast cancer in the renal transplant patient: a unique dilemma. Am Surg 2006, 72:150-153.
• [11]Luftner D, Flath B, Akrivakis C, Prinz B, Mergenthaler HG, Wernecke KD, Possinger K: Feasibility of dose-intensified paclitaxel after chemotherapy-induced renal insufficiency in a patient with renal transplantation. Eur J Cancer 1999, 35:325.
• [12]Allemani C, Sant M, Weir HK, Richardson LC, Baili P, Storm H, Siesling S, Torrella-Ramos A, Voogd AC, Aareleid T: Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer 2012, 132:1170-1181.
• [13]Greif JM, Pezzi CM, Klimberg VS, Bailey L, Zuraek M: Gender differences in breast cancer: analysis of 13,000 breast cancers in men from the national cancer data base. Ann SurgOncol 2012, 19:3199-3204.
• [14]Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK: SEER Cancer Statistics Review. Breast. Based on November 2007 SEER data submission, posted to the SEER website, 2008. National Cancer Institute. Besthesda, MD. Retrieved March 13, 2009: Edwards, B.K; 2008. http://seer.cancer.gov/csr/1975_2005/ webcite
• [15]Agraharkar ML, Cinclair RD, Kuo YF, Daller JA, Shahinian VB: Risk of malignancy with long-term immunosuppression in renal transplant recipients. Kidney Int 2004, 66:383-389.
• [16]Buell JF, Hanaway MJ, Trofe J, Gross TG, Beebe TM, Alloway RR, First MR, Woodle ES: De novo breast cancer in renal transplant recipients. Transplant Proc 2002, 34:1778-1779.
• [17]Sells RA: Iatrogenic problems caused by immunosuppressive drugs in transplant recipients. Transplant Proc 1998, 30:14.
• [18]Marcen R, Pascual J, Tato AM, Teruel JL, Villafruela JJ, Fernandez M, Tenorio M, Burgos FJ, Ortuno J: Influence of immunosuppression on the prevalence of cancer after kidney transplantation. Transplant Proc 2003, 35:1714-1716.