Malignancy in Renal Transplant Recipients / 대한이식학회지

The development of de novo malignancy in renal transplant recipient is one of the most troublesome problems during long-term follow-up. We reviewed our experience of malignancies in renal transplant recipients in SNUH. Among the 625 cases of renal transplantation performed in SNUH from July 1969 to July 1998, 18 cases of de novo malignancies developed in 17 patients: Kaposi sarcoma (6 cases), mucocutaneous cancer (5), post-transplant lymphoproliferative disease (2), bladder cancer (2), hepatoma (2), and stomach cancer (1). The cumulative incidences of cancer in 1, 5, and 10 years were 1.04%, 1.75%, and 2.63% respectively. Four cancers (3.7%) developed among the 109 patients who received azathioprine -based immunosuppression, and 14 cancers (2.7%) in cyclosporine-based immunosuppression. Malignancy was diagnosed at the age of 44.1 (range 25-59) years and 69.9 (range 2-177) months after kidney transplantation. Nine patients received surgical treatment including curative local excision in 5 and graft nephrectomy in one with PTLD in the allograft. Chemotherapy and radiotherapy was done in 7 and 2 patients respectively. Transarterial embolization was done in 1 patient with multiple hepatoma. Reduction or withdrawal of immunosuppression was performed in all patients except five, treated with curative local excision. Total 9 patients died and 3 graft loss occured in 3 survivors due to chronic rejections and allograft nephrectomy. The 5- and 10- year survival rate in the patients with malignancy was 79.3% and 50.5%, which is poorer than those without malignancy (88.6%, 83.0%; p<0.001). Careful surveillance of malignancy in renal allograft recipients is highly recommended.

Incidence and significance of Multiple Primary Malignant Neoplasms / 대한치료방사선과학회지

To know the three questions about multiple primary cancers: 1) what are the characteristics of persons having multiple primary cancer? 2) Dose presence of a single primary concer after the susceptibility to multiple primary cancers? 3) Dose the location of one multiple pripary cancer influence the site of others?, we analysed 121 cases of multiple primary malignant neoplasms registered in Seoul National University Hospital during 8years from July 1978 to August 1986. Of 121 cases, double primary malignant neoplasms were 119 cases and triple were 2 cases. The incidence of multiple primary malignant neoplasms was 0.7%. The metachronous tumor(> 6 months) was found in 70 cases and the median time between the first and the second was 32 months. The most commonly associated tumors were stomach and primary liver caroinoma. Cervix and Lung cancer, Stomach and Rectal cancer, Stomach and Esophagus cancer were also commonly associated.