Characteristics of Neoplasm Occurrence and the Therapeutic Effect of Sirolimus in South Chinese Kidney Transplant Recipients

Kidney transplantation (KTx) recipients are at a higher risk of oncogenesis when compared to the general population. Sirolimus (SRL), a potent immunosuppressant, has shown promising antineoplastic effects in vitro and in vivo. This study retrospectively analyzed the neoplasm occurrence and the efficiency of SRL on unresectable malignancies in South Chinese KTx recipients. Thirty-three (1.64%) of 2017 patients who received KTx from January 1984 to December 2004 developed neoplasms at 4 to 117 months posttransplant, mostly in digestive organs (33.3%), the hematologic system (15.2%), or the skin (12.1%). The most common type was liver cancer (24.2%), followed by skin cancer, lymphoma, and thyroid cancer (9.1%). The median survival times were 41.5 and 6.0 months for those who did ( n = 10) receive radical surgery or did not ( n = 23), respectively. The 20-month survival rates were 70.0% versus 13.0% ( P < .01). For unresectable patients, the median survival time of those treated with SRL ( n = 8) was 14.5 months compared to 3.0 months for those who did not ( n = 15). The survival rates at 12 th and 20 th months were 75.0% and 37.5% in the SRL group and 6.7% and 0% in the non-SRL group ( P < .05). In conclusion, when compared with Western studies, a lower incidence and unique location pattern (liver cancer-dominant) are characteristics of de novo posttransplant neoplasms in South Chinese KTx recipients. Early diagnosis and feasible radical surgery are favorable for prognosis, and SRL is a treatment of choice for KTx recipients with neoplasms.