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Multicenter Study
. 2025 Jun 16:38:14487.
doi: 10.3389/ti.2025.14487. eCollection 2025.

Renal Cell Carcinoma in Native Kidney After Kidney Transplantation: A Multicenter Case Control Study With a Focus on Screening Strategy

Pierre Pommerolle  1   2 , Maryam Assem  1   2   3 , Marine Uhl  4 , Philippe De Sousa  4 , Dominique Guerrot  5 , Marc Hazzan  6 , Thierry Lobbedez  7 , Ophélie Fourdinier  1 , Gabriel Choukroun  1   2
Affiliations
Multicenter Study

Renal Cell Carcinoma in Native Kidney After Kidney Transplantation: A Multicenter Case Control Study With a Focus on Screening Strategy

Pierre Pommerolle et al. Transpl Int. .

Abstract

Renal cell carcinoma (RCC) of native kidney is more prevalent after kidney transplantation than in the general population. Risk factors and the value of screening remain unclear. We conducted a multicenter case-control study in kidney transplant recipients transplanted between 1989 and 2017. All patients with RCC were included, and two controls were matched to each case. Two centers performed annual screening (AnS group) and the other two had other strategies (OS group). A total of 125 cancers were found in 113 patients. The majority of cancers were stage T1-T2 (92.0%), 1.6% had metastasis at diagnosis and ten (9.0%) had recurrence after nephrectomy. Men [OR 2.2; IC 95% (1.2-4.4); p = 0.02] and acquired cystic kidney disease [OR 3.2; IC 95% (1.8-5.9); p < 0.01] were associated with cancer in multivariate analysis. The 10-year survival was poorer in cases (65.6% vs. 79.1%, p < 0.001). The AnS group had fewer relapses (5.0% vs. 18.2%, p = 0.02) and a lower rate of cancer-related deaths (16.0% vs. 46.1%, p = 0.04). Survival of patients with RCC is lower than in control patients. Annual screening could improve cancer prognosis, its benefit needs to be evaluated in larger studies.

Keywords: kidney transplantation; native kidney; renal cell carcinoma; screening; survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Patient survival in cases and controls groups. Patient survival was measured from baseline, corresponding date of cancer diagnosis for cases and for controls on the date of cancer of the matched case.
FIGURE 2
FIGURE 2
Graft survival in cases and controls groups. Graft survival is censored on patient death and measured from baseline, corresponding date of cancer diagnosis for cases and for controls on the date of cancer of the matched case.
FIGURE 3
FIGURE 3
Repartition of 125 cancers in 113 patients. CCC, clear-cell carcinomas; PC, papillary carcinomas; Ch, chromophobes cancers.
FIGURE 4
FIGURE 4
Patients’ survival according to histologic type of RCC, clear-cell or papillary carcinomas. Patient survival is measured from date of cancer diagnosis. Five patients with CCC and PC were excluded from the analysis. CCC: clear-cells carcinomas; PC: papillary carcinomas.
FIGURE 5
FIGURE 5
Patients’ survival according to screening strategy. Patient survival is measured from date of cancer diagnosis. Ans, annual screening, OS, other strategy.
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