Gastric Adenocarcinoma after Renal Transplantation

ABSTRACT

PURPOSE: The incidence of malignancy in renal transplant recipients has been reported higher than in the general population. Despite gastric cancer being the most common malignancy in Korea, little is known about the incidence of gastric cancer after renal transplantation. This study was performed to find out the incidence and clinicopathological features of gastric cancer after renal transplantation in an endemic area for gastric adenocarcinoma. METHODS: Between April 1979 and March 2001, 11 gastric adenocarcinoma patients out of 2000 renal transplants at a single institute were reviewed retrospectively. RESULTS: In 5 male and 6 female patients with a mean age of 46.1 years (0.55% of kidney transplanted patients), stomach cancer occurred about 59 months after renal transplantation. Nine patients underwent a gastric resection with a curative intent while 2 with distant metastasis were treated symptomatically. None of the patients received any type of adjuvant therapy. There was no postoperative mortality although there were two postoperative complications, which were treated conservatively. Five patients survived without any evidence of recurrence, whereas 6 died due to recurrences or progression of gastric cancer. Three patients with early gastric cancers remain alive while all 4 stage IV patients died within 4 months of diagnosis. CONCLUSION: Renal transplant recipients are at an increased risk of a gastric adenocarcinoma, the most common malig nancy in Korea. With curative surgery, a favorable prognosis can be anticipated in patients with early gastric cancer after renal transplantation unless there is their diagnosis. Every effort for the early diagnosis should not be overlooked during the follow-up period. However, considering the worse prognoses and the more aggressive behaviors of advanced gastric cancer in renal transplant recipients, the value of adjuvant chemotherapy should be evaluated in the near future.