@article{3083840,
    title = "Study of “de novo” malignancies among Greek renal transplant
recipients",
    author = "Zavos, G and Bokos, J and Papaconstantinou, J and Boletis, J and and Gazouli, M and Pappas, P and Kostakis, A",
    journal = "Transplantation Proceedings",
    year = "2003",
    volume = "35",
    number = "4",
    pages = "1399-1403",
    publisher = "EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC",
    issn = "0041-1345",
    doi = "10.1016/S0041-1345(03)00518-9",
    abstract = "The incidence of malignancy was estimated in 1055 renal transplant
recipients, engrafted between 1983 and 2001 including 611 grafts from
living and 444 from cadaveric donors. The meoplasms were 22 skin
cancers, 18 Kaposi’s sarcomas, 10 lymphomas (nine non-Hodgkin’s and one
Hodgkin’s lymphoma) and 24 visceral carcinomas. Skin cancers were
completely excised. Patients with Kaposi sarcoma were treated by
tapering the immunosuppression with cessation of cyclosporine. In
addition, four patients received chemotherapy, and one of them received
local radiotherapy. All patients with lymphomas were treated by
cessation of calcineurin inhibitors with modulation of the
immunosuppression to levels that were safe for the graft. Furthermore,
five patients underwent first line chemotherapy, two patients
radiotherapy and two patients, surgical removal of the tumor. The
patients with visceral tumors were treated surgically with excision of
the lesions when possible, without severe modification of the
immunosuppressive regimen. Chemotherapy or radiotherapy was added
accordingly. Disease-related mortality rate in patients with skin cancer
was 4.5%; in Kaposi’s Sarcoma cases 11.11%; in lymphomas 50%; and in
all the other instances, 45.8%. This study shows the increased
incidence of certain malignancies in transplant recipients, illustrating
the importance of cancer surveillance following kidney transplantation.
A substantial reduction or even cessation of immunosuppressive therapy
may be necessary to achieve patient survival."
}