Factores de riesgo, manejo y supervivencia del cáncer vesical después de trasplante renal

Translated title of the contribution: Risk factors, management, and survival of bladder cancer after kidney transplantation

J. S. Jue, M. Alameddine, J. González, G. Ciancio

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction and objectives: Kidney transplantation is associated with an increased risk of bladder cancer; however guidelines have not been established on the management of bladder cancer after kidney transplantation. Materials and methods: A systematic literature review using PubMed was performed in accordance with the PRISMA statement to identify studies concerning the prevalence and survival of bladder cancer after kidney transplantation. The risk factors and management of bladder cancer after kidney transplantation were also reviewed and discussed. Results: A total of 41 studies, published between 1996 and 2018, reporting primary data on bladder cancer after kidney transplantation were identified. Marked heterogeneity in bladder cancer prevalence, time to diagnosis, non-muscle invasive/muscle-invasive bladder cancer prevalence, and survival was noted. Four studies, published between 2003 and 2017, reporting primary data on bladder cancer treated with Bacillus Calmette-Guérin (BCG) after kidney transplantation were identified. Disease-free survival, cancer-specific survival, and overall survival were similar between BCG studies (75-100%). Conclusions: Carcinogen exposure that led to ESRD, BKV, HPV, immunosuppressive agents, and the immunosuppressed state likely contribute to the increased risk of bladder cancer after renal transplantation. Non-muscle invasive disease should be treated with transurethral resection. BCG can be safely used in transplant recipients and likely improves the disease course. Muscle-invasive disease should be treated with radical cystectomy, with special consideration to the dissection and urinary diversion choice. Chemotherapy and immune checkpoint inhibitors can be safely used in regionally advanced bladder cancer with potential benefit. mTOR inhibitors may reduce the risk of developing bladder cancer, and immunosuppression medications should be reduced if malignancy develops.

Translated title of the contributionRisk factors, management, and survival of bladder cancer after kidney transplantation
Original languageSpanish
Pages (from-to)427-438
Number of pages12
JournalActas Urologicas Espanolas
Volume45
Issue number6
DOIs
StatePublished - Jul 1 2021
Externally publishedYes

Keywords

  • BCG
  • Bladder cancer
  • Kidney transplantation

ASJC Scopus subject areas

  • Urology

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