Solid‐type RCC originating from native kidneys in renal transplant recipients should be monitored cautiously

Incidental hemodialysis‐related renal cell carcinoma (id‐RCC) has been reported to have a good prognosis. However, we have observed rapid progression of id‐RCC in some renal transplant patients. Operative indications for id‐RCC detected via computed tomography (CT) immediately before renal transplantation (RTx) remain unclear. The purpose of this study was to examine the effects of immunosuppression on the progression of solid‐type RCC (s‐RCC) and cystic‐type RCC (c‐RCC). We divided 202 patients with id‐RCC into four groups as follows: Group 1, s‐RCC with RTx (n = 17); Group 2, c‐RCC with RTx (n = 27); Group 3, s‐RCC without RTx (n = 53); and Group 4, c‐RCC without RTx (n = 105). Five‐year cancer specific survival (CSS) rates were significantly worse in Group 1 than Group 3 (79.6% and 100%, respectively, P = 0.012), as were non‐recurrence rates (NRRs) (59.2 and 100%, respectively, P < 0.001). In contrast, 5‐year CSS rates were similar in Group 2 and Group 4 (100% and 95.7%, respectively, P = 0.295) as were NRR (100% and 98.7%, respectively, P = 0.230). Solid‐type RCC should be removed immediately after RTx, and more carefully monitored for recurrence during follow‐up.