PURPOSE: To evaluate the new treatment strategies in renal cell carcinoma (RCC) that affects the graft in renal recipients.
ACQUISITION OF EVIDENCE: A literature review is made, analyzing all the published cases of conservative surgery in renal graft RCC.
SYNTHESIS OF EVIDENCE: A total of 51 partial nephrectomies in renal graft patients have been described, with a graft survival rate of 88% and a recurrence rate of 6%. Most of the patients (75%) were asymptomatic at the time of diagnosis, and the mean lesion size was 2.8cm. Enucleation was the most frequent technique employed. 77% of all immunosuppressor regimens included cyclosporine A. Six patients with graft RCC were subjected to radiofrequency ablation and two patients underwent percutaneous cryoablation, with a single case of relapse and a graft survival rate of 100%.
CONCLUSIONS: Nephron-sparing surgery is a good management option in renal graft RCC, affording good oncological control and graft survival. Modification of immunosuppression with the withdrawal of cyclosporine A and the introduction of mTOR inhibitors is an adequate measure in such patients.
Written by:
González-López R, Bueno-Serrano G, Vázquez-Escuderos JJ, Mayor-De Castro J, González-Enguita C. Are you the author?
Servicio de Urología, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
Reference: Actas Urol Esp. 2013 Apr;37(4):242-248.
doi: 10.1016/j.acuro.2012.07.006.
PubMed Abstract
PMID: 23246102
Article in English, Spanish.
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