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Treatment options for localised renal cell carcinoma of the transplanted kidney

World Journal of Transplantation 2020年第6期10卷 147-161页

作者： Gloria Motta Mariano Ferraresso Luca Lamperti Dhanai Di Paolo Nicholas Raison Marta Perego Evaldo Favi Urology IRCCS Policlinico San DonatoSan Donato Milanese 27288Italy Renal Transplantation Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilan 20122Italy Department of Clinical Sciences and Community Health University of MilanMilan 20122Italy MRC Centre for Transplantation King’s College LondonLondon WC2R 2LSUnited Kingdom

Currently,there is no consensus among the transplant community about the treatment of renal cell carcinoma(RCC)of the transplanted *** recently,graftectomy was universally considered the golden standard,regardless of the characteristics of the *** to the encouraging results observed in native kidneys,conservative options such as nephron-sparing surgery(NSS)(enucleation and partial nephrectomy)and ablative therapy(radiofrequency ablation,cryoablation,microwave ablation,high-intensity focused ultrasound,and irreversible electroporation)have been progressively used in carefully selected recipients with early-stage allograft *** reports show excellent patient survival,optimal oncological outcome,and preserved renal function with acceptable complication ***,the rarity and the heterogeneity of the disease,the number of options available,and the lack of long-term follow-up data do not allow to adequately define treatment-specific advantages and *** role of active surveillance and immunosuppression management remain also *** order to offer a better insight into this difficult topic and to help clinicians choose the best therapy for their patients,we performed and extensive review of the *** focused on epidemiology,clinical presentation,diagnostic work up,staging strategies,tumour characteristics,treatment modalities,and follow-up *** research confirms that both NSS and focal ablation represent a valuable alternative to graftectomy for kidney transplant recipients with American Joint Committee on Cancer stage T1aN0M0 *** on T1bN0M0 lesions are scarce but suggest extra *** designed multi-centre prospective clinical trials are warranted.

关键词： Renal cell carcinoma Kidney transplant Graftectomy Nephron-sparing surgery focal ablation Review

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