Conservative treatment of renal cell carcinoma in kidney transplantation

• Published in: Actas urologicas españolas Vol. 37; no. 4; p. 242
• Main Authors: González-López, R, Bueno-Serrano, G, Vázquez-Escuderos, J J, Mayor-De Castro, J, González-Enguita, C
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-04-2013
• Subjects: Carcinoma, Renal Cell - surgery; Humans; Kidney Neoplasms - surgery; Kidney Transplantation; Postoperative Complications - surgery
• ISSN: 1699-7980
• DOI: 10.1016/j.acuro.2012.07.006

To evaluate the new treatment strategies in renal cell carcinoma (RCC) that affects the graft in renal recipients.
A literature review is made, analyzing all the published cases of conservative surgery in renal graft RCC.
A total of 51 partial nephrectomies in renal graft patients have been described, with a graft survival rate of 88% and a recurrence rate of 6%. Most of the patients (75%) were asymptomatic at the time of diagnosis, and the mean lesion size was 2.8 cm. Enucleation was the most frequent technique employed. 77% of all immunosuppressor regimens included cyclosporine A. Six patients with graft RCC were subjected to radiofrequency ablation and two patients underwent percutaneous cryoablation, with a single case of relapse and a graft survival rate of 100%.
Nephron-sparing surgery is a good management option in renal graft RCC, affording good oncological control and graft survival. Modification of immunosuppression with the withdrawal of cyclosporine A and the introduction of mTOR inhibitors is an adequate measure in such patients.