TY - JOUR
T1 - Long-Term Risk of Cancer in Survivors of Pediatric ESRD
AU - Ploos van Amstel, Sophie
AU - Vogelzang, Judith L.
AU - Starink, Marcus V.
AU - Jager, Kitty J.
AU - Groothoff, Jaap W.
PY - 2015
Y1 - 2015
N2 - ESRD is associated with an increased risk of malignancies. We analyzed the incidence of cancer in patients with pediatric ESRD after long-term follow-up. All Dutch patients born before 1979 who were transplanted at age <15 years old in 1972-1992 were followed until 2010. We explored type and incidence of malignancies in patients compared with the general population using the National Cancer Registry. After a median of 25.3 years (1.3-37.8) of transplantation and at a median age of 33.5 years old (11.0-49.0), 105 primary malignancies had occurred in 54 of 249 patients. Among them, cutaneous squamous cell carcinoma was most frequent. Patients ages 25-30 years old had developed 16.5 times (95% confidence interval, 7.9 to 34.6) as many de novo tumors and 991 times (95% confidence interval, 313 to 3137) as many de novo cutaneous squamous cell carcinomas as their general population counterparts; in survivors ages 45-50 years old, these numbers were 81.5 (95% confidence interval, 50.7 to 131.1) and 2610 (95% confidence interval, 1596 to 4267), respectively. Cumulative incidence competing risk analysis showed that, after 30 years of transplantation, 41% of the survivors had developed cancer; 31% had developed a second de novo cancer <1 year after initial cancer diagnosis. Cancer is highly prevalent among patients with pediatric ESRD after 25.3 years of transplantation, with a high rate of recurrence
AB - ESRD is associated with an increased risk of malignancies. We analyzed the incidence of cancer in patients with pediatric ESRD after long-term follow-up. All Dutch patients born before 1979 who were transplanted at age <15 years old in 1972-1992 were followed until 2010. We explored type and incidence of malignancies in patients compared with the general population using the National Cancer Registry. After a median of 25.3 years (1.3-37.8) of transplantation and at a median age of 33.5 years old (11.0-49.0), 105 primary malignancies had occurred in 54 of 249 patients. Among them, cutaneous squamous cell carcinoma was most frequent. Patients ages 25-30 years old had developed 16.5 times (95% confidence interval, 7.9 to 34.6) as many de novo tumors and 991 times (95% confidence interval, 313 to 3137) as many de novo cutaneous squamous cell carcinomas as their general population counterparts; in survivors ages 45-50 years old, these numbers were 81.5 (95% confidence interval, 50.7 to 131.1) and 2610 (95% confidence interval, 1596 to 4267), respectively. Cumulative incidence competing risk analysis showed that, after 30 years of transplantation, 41% of the survivors had developed cancer; 31% had developed a second de novo cancer <1 year after initial cancer diagnosis. Cancer is highly prevalent among patients with pediatric ESRD after 25.3 years of transplantation, with a high rate of recurrence
U2 - https://doi.org/10.2215/CJN.03630415
DO - https://doi.org/10.2215/CJN.03630415
M3 - Article
C2 - 26430089
SN - 1046-6673
VL - 10
SP - 2198
EP - 2204
JO - Clinical journal of the American Society of Nephrology
JF - Clinical journal of the American Society of Nephrology
IS - 12
ER -