Nephron sparing surgery for De Novo kidney graft tumor: results from a multicenter national study.
Fiche publication
Date publication
septembre 2014
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HUBERT Jacques, Pr KLEINCLAUSS François
Tous les auteurs :
Tillou X, Guleryuz K, Doerfler A, Bensadoun H, Chambade D, Codas R, Devonec M, Dugardin F, Erauso A, Hubert J, Karam G, Salomon L, Sénéchal C, Salusto F, Terrier N, Timsit MO, Thuret R, Verhoest G, Kleinclauss F,
Lien Pubmed
Résumé
Nephron sparing surgery (NSS) results in the transplanted population remain unknown because they are only presented in small series or case reports. Our objective was to study renal sparing surgery for kidney graft renal cell carcinomas (RCC) in a multicenter cohort. Data were collected from 32 French transplantation centers. Cases of renal graft de novo tumors treated as RCC since the beginning of their transplantation activity were included. Seventy-nine allograft kidney de novo tumors were diagnosed. Forty-three patients (54.4%) underwent renal sparing surgery. Mean age of grafted kidneys at the time of diagnosis was 47.5 years old (26.1-72.6). The mean time between transplantation and tumor diagnosis was 142.6 months (12.2-300). Fifteen tumors were clear cell carcinomas (34.9%), and 25 (58.1%) were papillary carcinomas. Respectively, 10 (24.4%), 24 (58.3%) and 8 (19.5%) tumors were Fuhrman grade 1, 2 and 3. Nine patients had postoperative complications (20.9%) including four requiring surgery (Clavien IIIb). At the last follow-up, 41 patients had a functional kidney graft, without dialysis and no long-term complications. NSS is safe and appropriate for all small tumors of transplanted kidneys with good long-term functional and oncological outcomes, which prevent patients from returning to dialysis.
Mots clés
Clinical research, kidney disease, kidney transplantation, malignancy, malignant, neoplasia, nephrology, practice, surgical technique, urology cancer
Référence
Am. J. Transplant.. 2014 Sep;14(9):2120-5