Nephron Sparing Surgery for De Novo Kidney Graft Tumor: Results From a Multicenter National Study

18 février 2018

Auteurs : X. Tillou, K. Guleryuz, A. Doerfler, H. Bensadoun, D. Chambade, R. Codas, M. Devonec, F. Dugardin, A. Erauso, J. Hubert, G. Karam, L. Salomon, C. Sénéchal, F. Salusto, N. Terrier, M. O. Timsit, R. Thuret, G. Verhoest, F. Kleinclauss and the members of the Renal Transplantation Committee of the French Urological Association (CTAFU)
Référence : American Journal of Transplantation 2014; XX: 1–6

Nephron sparing surgery (NSS) results in the transplanted population remain unknown because they are only presented in small series or case reports. Our objective was to study renal sparing surgery for kidney graft renal cell carcinomas (RCC) in amulticenter cohort. Data were collected from 32 French transplantation centers. Cases of renal graft de novo tumors treated as RCC since the beginning of their transplantation activity were included. Seventy-nine allograft kidney de novo tumors were diagnosed. Forty-three patients (54.4%) underwent renal sparing surgery. Mean age of grafted kidneys at the timeof diagnosiswas 47.5 years old (26.1– 72.6). The mean time between transplantation and tumor diagnosis was 142.6 months (12.2–300). Fifteen tumors were clear cell carcinomas (34.9%), and 25 (58.1%) were papillary carcinomas. Respectively, 10 (24.4%), 24 (58.3%) and 8 (19.5%) tumors were Fuhrman grade 1, 2 and 3. Nine patients had postoperative complications (20.9%) including four requiring surgery (Clavien IIIb). At the last follow-up, 41 patients had a functional kidney graft, without dialysis and no long-term complications. NSS is safe and appropriate for all small tumors of transplanted kidneys with good long-term functional and oncological outcomes, which prevent patients from returning to dialysis.