Incidence and clinical course of de-novo malignancies in renal allograft recipients

Background: This study was designed to evaluate the development of malignancies after renal transplantation in a single centre. The outcome was studied in patients developing a malignant neoplasm after renal transplantation. Methods: Malignancies are registered in a database containing relevant data about the patients with a renal transplant. This database and the files of the patients developing a malignant neoplasm, have been studied as to stage at presentation, therapy and outcome. Results: In 1546 patients with 2075 renal transplantations, 240 malignancies developed in 231 recipients. Skin cancers often present with more than one lesion of the same histological type. After the first skin tumour, about half of the patients developed more lesions, of the same or a different histological type. The prognosis of skin tumours is relatively good, but most malignancies in all other categories have a poor prognosis. Conclusions: Cutaneous neoplasms tend to be multiple, but can be controlled by regular examination of the skin. Most malignant lymphomas do develop outside the lymphoproliferative system and have a poor prognosis. Patients with a solid tumour of the other tracts often present in an advanced stage of disease, which makes the outcome of treatment, if possible at all, disappointing.