Yonsei Med J.  2011 May;52(3):454-462. 10.3349/ymj.2011.52.3.454.

Clinical Characteristics and Treatment Outcomes of Colorectal Cancer in Renal Transplant Recipients in Korea

• Kim JY
• Ju MK
• Kim MS
• Kim NK
• Sohn SK
• Kim SI
• Kim YS

• KMID: 1777017
• DOI: http://doi.org/10.3349/ymj.2011.52.3.454

Abstract

PURPOSE
Transplant recipients in Asia appear to be at a higher risk for developing colorectal cancer (CRC). This study was performed to identify the clinicopathological features and oncologic outcomes of CRC in post-renal transplants in Korea.
MATERIALS AND METHODS
We retrospectively reviewed the records of 17 patients with CRC out of 2,630 recipients who underwent renal transplantation between 1994 and 2007. These patients (transplant group) were compared with general CRC patients (n=170, control group) matched, based on the closest date of surgery to the transplant group.
RESULTS
During 29.7 months of the median follow-up period, the recurrent and survival rates from recurrence were worse in the transplant group than in the control group (35.2% versus 15.2%; p=0.048 and p=0.025). The 2-year patient survival rate of the transplant group was significantly worse than the control group in advanced cancer (stages III-IV; 45.7% versus 71.6%; p=0.023). In early cancer (stages 0-I), there was no significant difference in 5-year patient survival rate between the two groups (100% versus 92.6%, respectively; p=0.406).
CONCLUSION
In spite of a poor prognosis of advanced CRC in the transplant group, the early stage CRC of the transplant group showed a comparable oncologic outcome compared with the control group. Regular screening and early detection of CRC are essential in the post-transplant setting.

Keyword

Colorectal cancer; post-transplant malignancy; oncologic outcome

MeSH Terms

Adult
Colorectal Neoplasms/chemically induced/diagnosis/epidemiology/*therapy
Female
Humans
Immunosuppressive Agents/adverse effects
Incidence
*Kidney Transplantation
Male
Middle Aged
Prognosis
Republic of Korea
Retrospective Studies
Treatment Outcome

Figure

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  Fig. 1 Overall patient survival rate. Transplant group showed inferior survival rate compared with control group (p=0.044).

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  Fig. 2 Survival rate by pathologic staging. Early staged transplant group showed survival rate comparable to control group (p=0.406)(A), but advanced staged transplant group showed extremely poor survival rate compared with control group (p=0.023)(B).

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  Fig. 3 The advanced staged colorectal cancer (CRC) in transplant group which were treated with adjuvant chemotherapy also showed poor survival rate compared with advanced stage CRC in control group who were treated with adjuvant chemotherapy (p=0.031).

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  Fig. 4 Survival rate after tumor recurrence. Transplant group had poor survival rate after tumor recurrence compared with control group (p=0.025).

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