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Introduction <p>Kidney transplant recipients (KTRs) have a markedly increased risk of malignancy due to chronic immunosuppression and oncogenic exposures. This study describes the spectrum, management, and outcomes of post-transplant malignancies over nearly six decades at a tertiary center.</p> Methods <p>We conducted a retrospective study of adult KTRs at the National Institute of Nutrition (1967–2024). Patients with post-transplant malignancy and complete clinical records were included. Demographic data, immunosuppressive regimens, tumor characteristics, treatment, and survival were analyzed. Tumor-level and patient-level denominators were reported separately.</p> Results <p>Among 1,419 KTRs, 116 developed cancer and 98 had complete records, accounting for 136 malignancies. Per tumor, non-melanoma skin cancer represented 41% (56/136), genitourinary (GU) cancers 27% (37/136), and lymphomas 12% (16/136). At the patient level, 61% were male and 51% were older than 50&#xa0;years at diagnosis. Three EBV-positive post-transplant lymphoproliferative disorders were identified. Most tumors were localized (86%) and surgically treated (84%). Median overall survival after cancer diagnosis was 19.0&#xa0;years (1-, 3-, and 5-year survival: 0.90, 0.84, and 0.82), while cancer-specific and disease-free survival did not reach median (5-year: 0.96 and 0.88). On multivariable analysis, mycophenolate mofetil (MMF) use was independently associated with a GU malignancy phenotype (OR 4.79; 95% CI 1.11–20.70). Age &gt; 50&#xa0;years was associated with worse overall survival on log-rank testing.</p> Conclusions <p>In this long-term cohort, non-melanoma skin and GU cancers were the most common post-transplant malignancies. Most tumors were detected at localized stages, yet older age and immunosuppressive exposure influenced cancer phenotype and prognosis. EBV-related PTLD was documented. These findings support tailored oncologic surveillance —emphasizing dermatologic evaluation, renal imaging of native and graft kidneys, risk-adapted PSA testing— and careful immunosuppression modulation.</p>

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Incidence and outcomes of malignancies in renal transplant recipients: a 57-year single-center experience

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Librado Jonas Baños-Peña,
  • Horst Emanuel Lagos-Beitz,
  • Luis Iván Aguirre-Anaya,
  • Lluvia A. Marino-Vazquez,
  • Gerardo Tena Gonzalez-Mendez,
  • Bernardo Gabilondo-Pliego,
  • Ricardo Alonso Castillejos-Molina

摘要

Introduction

Kidney transplant recipients (KTRs) have a markedly increased risk of malignancy due to chronic immunosuppression and oncogenic exposures. This study describes the spectrum, management, and outcomes of post-transplant malignancies over nearly six decades at a tertiary center.

Methods

We conducted a retrospective study of adult KTRs at the National Institute of Nutrition (1967–2024). Patients with post-transplant malignancy and complete clinical records were included. Demographic data, immunosuppressive regimens, tumor characteristics, treatment, and survival were analyzed. Tumor-level and patient-level denominators were reported separately.

Results

Among 1,419 KTRs, 116 developed cancer and 98 had complete records, accounting for 136 malignancies. Per tumor, non-melanoma skin cancer represented 41% (56/136), genitourinary (GU) cancers 27% (37/136), and lymphomas 12% (16/136). At the patient level, 61% were male and 51% were older than 50 years at diagnosis. Three EBV-positive post-transplant lymphoproliferative disorders were identified. Most tumors were localized (86%) and surgically treated (84%). Median overall survival after cancer diagnosis was 19.0 years (1-, 3-, and 5-year survival: 0.90, 0.84, and 0.82), while cancer-specific and disease-free survival did not reach median (5-year: 0.96 and 0.88). On multivariable analysis, mycophenolate mofetil (MMF) use was independently associated with a GU malignancy phenotype (OR 4.79; 95% CI 1.11–20.70). Age > 50 years was associated with worse overall survival on log-rank testing.

Conclusions

In this long-term cohort, non-melanoma skin and GU cancers were the most common post-transplant malignancies. Most tumors were detected at localized stages, yet older age and immunosuppressive exposure influenced cancer phenotype and prognosis. EBV-related PTLD was documented. These findings support tailored oncologic surveillance —emphasizing dermatologic evaluation, renal imaging of native and graft kidneys, risk-adapted PSA testing— and careful immunosuppression modulation.