Malignancy is the third most cause of death among kidney transplantation recipients after cardiovascular events and infection. The aim of this study was to investigate the types of and risk factors for cancer excluding skin lesions among kidney transplantation (KT) patients in Portugal. We studied retrospectively the 1695 patients who underwent KT between 1983 and 2009. Malignancies post-KT were considered if diagnosed at least 1 year after KT. The results were compared with a group of cancer free patients. During the follow-up period to June 2010, which included a median duration of 118.49 months (interquartile range 53.34 to 182.46), 60 patients (3.5%) developed 66 malignancies, which were the cause of death in 17. Compared with patients without cancer, the affected ones were older (P < .001), and had a longer duration of graft function (P = .002). There were no significant differences regarding gender, follow-up time, actue rejection episodes, donor type, number of KT, immunosuppressive regimen. The most frequent malignancy was colorectal cancer (21.2%), followed by malignant lymphoma (16.7%) and breast cancer (13.6%). The mean age of patients at diagnosis was 53.9 ± 11.5 years. The average time for development of a cancer was 8.3 ± 5.7 years with 42.4% detected between 1 and 5 years. In total, 16 patients were converted to sirolimus. Patient survival was significantly lower among subjects with cancer; censored graft survival was significantly higher in this group. A multivariate logistic regression analysis identified risk factors for malignancy post-KT to be recipient age and duration of follow-up. In conclusion, our data showed a significant number of tumors that generally not described to be higher lesions among KT. We achieved an early diagnosis and a lack of impact on death-censored graft survival.
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