NEW YORK (Reuters Health) - Kidney transplant recipients appear to have an increased risk of de novo renal cell carcinoma in their native kidneys, according to a report in the January 15th issue of Cancer.

A multicenter French team led by Dr. Yann Neuzillet of Hopital Salvator in Marseille, France reports on the incidence of renal cell carcinoma in 933 consecutive patients who underwent kidney transplantation between 1987 and 2003. Eleven of the subjects (1.2%) developed 12 de novo malignancies in their native kidneys, compared with an estimated rate of renal carcinoma in the general population of 0.12%. Two of the cancers were symptomatic; the others were discovered "fortuitously," the authors write.

The 12 malignancies included 7 conventional cell carcinomas, 3 basophilic papillary carcinomas, and 2 chromophobic renal cell carcinomas. "Half of all tumors were Fuhrman Grade 3 lesions, and pT1aN0M0 tumors (2003 TNM staging system) also accounted for half of all malignancies," the researchers reported.

Ten patients underwent nephrectomy, including one who had both kidneys removed. At an average follow-up of 39 months, 9 patients were alive with no evidence of disease. One patient died of metastatic renal cell cancer 2 months after diagnosis, and one patient died of pulmonary tuberculosis.

"There appears to be an increased risk of malignancy of the native kidney in renal transplant recipients, with high-grade and papillary tumors being particularly common," the investigators conclude. "Consequently, systematic radiologic follow-up of native kidneys must be performed for individuals who undergo kidney transplantation."

Cancer 2005;103:251-257.

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