EURURO Vol. 73 No. 1

94 148

Platinum Priority – Review – Renal Disease
Editorial by Javier Burgos-Revilla and Victoria Gomez-Dos-Santos on pp. 109–110 of this issue
The Risk of Tumour Recurrence in Patients Undergoing Renal
Transplantation for End-stage Renal Disease after Previous
Treatment for a Urological Cancer: A Systematic Review
Romain Boissier
Enrique Lledo´-Garcı´a
Rhana Hassan Zakri
a Department of Urology & Renal Transplantation, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France; bUrology Department,
Hospital Universitario Ramón y Cajal, Alcalá University, Madrid, Spain; c Department of Urology, Radboudumc, Nijmegen, The Netherlands; d Department of
Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany; e Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra,
Portugal; f Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; g Department of Urology & Renal Transplantation Guy’ s
and St Thomas’ Hospital, London, England, UK; hClinical Institute of Pathology, Medical University of Vienna, Vienna, Austria; i Department of Urology and
Renal Transplantation St George’s Hospital, London, England, UK; j Department of Medicine, Health Science Centre, McMaster University, Hamilton, ON,
Canada; k Department of Urology, Fundacion Puigvert, University Autonoma of Barcelona, Barcelona, Spain
available at
journal homepage:
Article info
Article history:
Accepted July 17, 2017
Associate Editor:
James Catto
Keywords:
Renal transplantation
Prostate cancer
Renal cancer
Urothelial carcinoma
Testicular cancer
Systematic review
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Abstract
Context: Renal transplantation is the gold standard renal replacement therapy in end-
stage renal disease owing to its superior survival and quality of life compared with
dialysis. When the potential recipient has a history of cancer, the waiting period before
renal transplantation is usually based on the Cincinnati Registry.
Objective: To systematically review all available evidence on the risk of cancer recur-
rence in end-stage renal disease patients with a history of urological cancer.
Evidence acquisition: Medline, Embase, and the Cochrane Library were searched up to
March 2017 for all relevant publications reporting oncologic outcomes of urological
cancer in patients who subsequently received a transplantation or remained on dialysis.
The primary outcome was time to tumour recurrence. Secondary outcomes included
cancer-specific and overall survival. Data were narratively synthesised in light of
methodological and clinical heterogeneity. The risk of bias of each included study
was assessed.
Evidence synthesis: Thirty-two retrospective studies enrolling 2519 patients (1733 dia-
lysed, 786 renal transplantation) were included. For renal cell carcinomas, the risks of
recurrence, cancer-specific, and overall survival were similar between transplantation
and dialysis. For prostate cancer, most of the tumours had favourable prognoses
consistent with nomograms. Studies dealing with urothelial carcinomas (UCs) mainly
included upper urinary tract UC in the context of aristolochic acid nephropathy, for
which the risks of synchronous bilateral tumour and recurrence were high. Data on
testicular cancer were scarce.
Conclusions: Immunosuppression after renal transplantation does not affect the
outcomes and natural history of low-risk renal cell carcinomas and prostate
cancer. Therefore, the waiting time from successful treatment for these cancers to
y These authors contributed equally to this manuscript and share fi rst authorship.
* Corresponding author. Department of Urology and Renal Transplantation, Puigvert Foundation,
Carrer de Cartagena, 08025?Barcelona, Spain. Tel. +34 934169700; Fax: +34 934169730.
E-mail address: (A. Breda).
0302-2838/© 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.