Management of bladder cancer after renal transplantation Journal Article
| Authors: | Prabharasuth, D.; Moses, K. A.; Bernstein, M.; Dalbagni, G.; Herr, H. W. |
| Article Title: | Management of bladder cancer after renal transplantation |
| Abstract: | Objective: To review our experience managing bladder cancer (BCa) in patients who have had renal transplantation. Optimal oncologic treatment can be challenging due to the immunosuppressed state and higher comorbidity. Methods: From January 2000 to August 2011, we identified 17 patients with a history of renal transplantation who were treated for BCa. Clinical, demographic, and oncologic data were collected. Patients treated with intravesical bacillus Calmette-Guérin (BCG) were assessed for complications. Results: BCa diagnosis occurred at a median of 88.1 months after renal transplantation. Median age was 62.4 years and median follow-up was 9.2 months. The most common presentation was gross hematuria (58.8%), and the median Charlson comorbidity index was 5. Twelve patients were identified with non-muscle invasive (NMI) BCa. Four patients with NMI BCa received intravesical BCG, with no urinary tract infection, fever, or BCG-associated sepsis. Four patients were identified with muscle-invasive bladder cancer (MIBC), and 1 patient had biopsy proven metastatic disease. Five patients underwent radical cystectomy (RC) with diversion, 7 underwent transurethral resection and surveillance, 3 underwent chemotherapy, and 1 received palliative radiation for metastatic disease. Overall, 6 patients were deceased, 4 of whom died of disease at a median of 9.7 months from the time of BCa diagnosis. Conclusion: Treatment of patients with BCa after renal transplantation is challenging because of immunosuppression and overall high comorbidity. Optimal management with stage-appropriate therapy should be considered in appropriate patients. Intravesical BCG may be considered in select patients, although overall efficacy may be reduced. © 2013 Elsevier Inc. |
| Journal Title: | Urology |
| Volume: | 81 |
| Issue: | 4 |
| ISSN: | 0090-4295 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2013-04-01 |
| Start Page: | 813 |
| End Page: | 819 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 23290344 |
| DOI: | 10.1016/j.urology.2012.11.035 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 May 2013" - "CODEN: URGYA" - ":doi 10.1016/j.urology.2012.11.035" - "Source: Scopus" |
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