103 148
Table 7
–
Oncological outcomes of included patients with a history of urothelial carcinoma: renal transplantation (I) versus renal replacement therapy (C)
Study (1st author, yr)
Primary
management
Arms (no. of patients)
Oncological outcomes
Histological outcomes
Follow-up
a(yr)
Recommendations concerning waiting
period & prognostic factors of
recurrence, according to authors of the
included studies
Cancer
recurrence
Cancer
speci
fi
c
survival
Overall
survival
Location
Stage
Grade
5 yr
>
5 yr
Chapman, 2001
[46]
NS
I (24)
NS
4.2% NS
NS
NS
NS
NS
NS
-Prognostic factor of recurrence:
- Diagnosis of cancer while on
dialysis vs before dialysis
- Waiting period:
-
>
2 yr
-
>
5 yr if cancer diagnosed while on
dialysis
C (93)
NS
24% NS
NS
Penn, 1997
[4]
NS
I (55)
NS
29% NS
NS
NS
NS
NS
>
5
- Bladder cancer = high risk of
recurrence
- Waiting period:
- 2 yr for low-grade bladder cancer
-
>
5 yr for high-grade bladder cancer
Joshi, 2008
[29]
1 TURB
I (1)
0% 0% 100% (
>
5 yr) 100% (
>
5 yr) Bladder 100% T1 100%
G2 100% 9
Chang, 2007
[42]
8 NUT
4 NUT + TURB
I (12)
NS
NS
96% (1
–
5 yr) 79% (1
–
5 yr) Bladder 65%
Ureter 42%
Renal pelvis 15%
Multifocal 27%
Ta 12%
T1 69%
T2 15%
T4bN1M1 4%
G1 12%
G2 73%
G3 15%
1.6
- High rate of contralateral tumour
- Do not recommend systematic
contralateral NUT but close
monitoring before transplantation
Hung, 2009
[43]46 NUT
C (46)
NS
32% 98% (
>
5 yr) 88% (
>
5 yr) Bladder 29%
UUT 71%
Multifocal 54%
T1
–
2 71%
T3
–
4 29%
G1 9%
G2
–
3 91%
12.6
Kang, 2010
[21]13 NUT
64 NUT + cystectomy
C (67)
NS
53% 96% (
>
5 yr) 43% (
>
5 yr) UUT 100%
Ta/T1 56%
T2 14%
T3
–
4 30%
G1 17%
G2 30%
G3 53%
5 (5.6
–
10.2) - Synchronous contralateral tumour
10%
- Asynchronous bladder tumour 39%
- Do not recommend systematic
bilateral NUT before transplantation
but close monitoring
Li, 2016
[44]
72 TURB + intravesical
chemotherapy
(BCG excluded)
C (72)
40% 57% NS
60% (
>
5 yr) Bladder 100% Ta 66%
T1 34%
G1
–
2 31%
G3
–
4 69%
5.2 (4
–
7)
Ou, 2000
[45]
2 NUT
1 NUT + TURB
11 TURB
C (17)
50% NS
92% (1
–
5 yr) 75% (1
–
5 yr) Bladder + UUT Stage 0/A 82%
Stage B1 6%
Unknown Stage 12%
NS
NS
Wu, 2006
[20]
28 NUT unilateral
4 NUT bilateral
23 Urinary tract
exenteration
C (55)
55% NS
86% (
>
5 yr) 86% (1
–
5 yr) Bladder + UUT Ta 46%
T1 19%
T2 12%
T3 22%
T4 1%
G1 5%
G2 70%
G3 25%
2.5
- Bilateral involvement 16%
- Contralateral recurrence 31%
- Propose: bilateral NUT for young
patients and waiting period 2 yr
before transplantation
C = control; I = intervention; NS = not stated; NUT = nephroureterectomy; TURB = transurethral bladder resection; UC = urothelial cancer; UUT = upper urinary tract
.
a
From cancer treatment to last news.
E U R O P E A N U R O L O GY 7 3 ( 2 0 18 ) 9 4
–
10 8
103