Objective: To study the prevalence, treatment and outcome of urothelial bladder tumours (UBT) in renal transplant recipients.
Patients and methods: Multicentre retrospective study performed in 2004 by questionnaire sent to members of the AFU Transplantation Committee.
Result: Seven centres returned the questionnaire with a total of 32 UBTs in 21 males and 3 females with a mean age of 63.2 +/- 10.1 years, with no history of UBT. The incidence was 255 per 100,000. The median interval between transplantation and UBT was 60 months (range: 5 to 259 months). 72% of UBTs were stage pT > or = 1 and 63% were grade 3. CIS was present in 20% of cases. 25% of patients were N+. In addition to resection of the UBT, 3 patients were also treated with mitomycin C and 1 was treated with BCG. 7 patients underwent cystectomy, with a palliative objective in 42% of cases, associated with radiotherapy-chemotherapy (2/3) or chemotherapy alone (1/3). Immunosuppressive therapy was decreased in 50% of cases. Six patients (25%) died from bladder cancer, 25% relapsed with a tumour progression rate of 50%. 46% of patients were in remission of their UBT 4% died from an intercurrent cause. 76% of survivors have a Junctional graft with no alteration of serum creatinine.
Conclusion: Renal transplant recipients have an increased incidence of UBT, which are more aggressive and associated with a higher mortality compared to the general population. Increased surveillance and aggressive treatment therefore appear to be justified.