*Purpose: Previous studies have recommended a 2-5-year waiting time prior to kidney transplantation (KT) in patients with end-stage renal disease (ESRD) and symptomatic renal cell carcinoma (RCC) and no delay for incidental early-stage RCC. Data on Asian kidney transplant recipients are unavailable.

*Methods: This is a Korean single-center retrospective study on 35 KT recipients with ESRD and RCC (Figure 1). Patients were classified into two groups: early KT (KT performed within 1 year after nephrectomy for RCC, including KT with simultaneous nephrectomy) and delayed KT (KT performed > 1 year after nephrectomy for RCC). Patient survival, graft survival, and cancer recurrence were compared between both groups.

*Results: There were no statistically significant differences in patient survival (P = 0.388, Figure 2A), graft survival (P = 0.317, Figure 2B), or graft rejection rate (P = 0.207) between the early and delayed KT groups. Additionally, there were no differences in pathological characteristics and RCC stage other than cancer histology: acquired cystic disease-associated RCC (47.4%) was the most common RCC type in the early KT group, whereas clear cell type (66.7%) was the most common RCC type in the delayed KT group. No RCC recurrence was observed.

*Conclusions: Patients with early-stage and asymptomatic RCC do not require a mandatory observational period prior to KT after curative nephrectomy.

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