Cancer in renal allograft recipients in Australia and New Zealand.

Total incidence and outcome of cancer in all renal allograft recipients in one geographic area are known: 126 (7%) of 1884 patients developed cancer during an 11-year period. Proportions with cancer 1 and 5 years following successful transplantation were 11% and 24%, respectively. Numbers, proportion of malignancies, and average time of diagnosis post transplantation were as follows: reticulum cell sarcoma (RCS) 15 (11%), 18 months; adenocarcinoma 8 (6%), 21/2 years; cancer of cervix 6 (5%), 41/2 years; leukemia 2 (2%), 5 years. All were highly malignant except cancer of the cervix, 2 localized forms of RCS, and 4 cases of cerebral RCS that responded to radiotherapy. Skin malignancy (SM) occurred in 97 patients (77% of cancers). The frequency increased with time, and after 4 years 18% of survivors had this cancer. In patients with SM 17% had multiple lesions when first diagnosed; further cancers or recurrences of the same type developed in 23%; another form of SM developed in 15%; metastases occurred 9 times (9%), 4 fatally. Six (6%) patients with SM developed other forms of malignancy, as compared to 33 (2%) of 1786 patients without SM. Ooulook for patients with SM with regard to survival and graft function was greatly improved at 5 years, as compared to that for patients without SM. Thereafter the outlook for patients with SM worsened rapidly because of additional effects of malignancy.