Objective: According to our published data, upper tract urothelial carcinoma (UTUC) is the predominant malignancy among Chinese renal transplanted patients. This is quite different from western countries in which non-melanoma skin cancer and post-transplant lymphoproliferative disorder (PTLD) are the most common malignancy. Although the surgical intervention is recommended, due to the fast progression, post-transplant UTUC is always intractable and has poor prognosis. Present study is to assess the safety and the efficacy of platinum-based chemotherapy (CT) in renal transplant (RT) patients with muscle invasive UTUC (MIUTUC).

Methods: We retrospectively reviewed the records of 29 RT patients with MIUTUC who regularly followed up in our hospital since January 2002. All patients received radical nephroureterectomy (RU), then was treated with gemcitabine (800 mg/m²) plus cisplatin (70 mg/m²)/carboplatin (AUC=5) every 28 days or only regularly followed up.

Results: 14 patients received adjuvant chemotherapy 1 month after RU (Group I), and the other 15 patients treated with RU only was grouped as control (Group II). Comparing group I and II, the baseline of demographic and oncologic data was no different. In group I, 14 patients received a median of four cycles' chemotherapy, the most common toxicities were myelosuppression and gastrointestinal effects and no severe renal and urinary disorder was observed. Disease-free rate for Group I & II was 54.3% and 26.7% at 2 years. Disease-free survival (DFS) of the patients treated with chemotherapy was better than those treated by RU only. Conclusion: The CT was shown to be effective and tolerable in RT patients with MIUTUC. Platinum-based CT regimen was safe for transplanted kidney function. Further studies involving more patients and long-term overall survival are required.

CITATION INFORMATION: Zhu Y, Lin J. The Effiency and Safety of Chemotherapy for Urothelial Carcinoma in Post-Kidney Transplanted Patients. Am J Transplant. 2017;17 (suppl 3).

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