Recurrence of Malignancy after Transplantation ANZDATA Australian and

Recurrence of Malignancy after Transplantation ANZDATA - Australian and New Zealand Dialysis and Transplant Registry NSW Cancer Council

Recurrence of Malignancy ISSUES • Donor • Recipient

Timing of Cancer Diagnosis PRE Dx POST Dx DIALYSIS CANCER Tx DEATH

Number of Patients with Cancer ANZDATA Database 1999 Cancer Pre Dx Post Dx Skin 454 777 Kidney 406 73 Myeloma 192 20 Bladder 162 93 Breast 141 66 Colon 129 56 Prostate 126 42 Melanoma 95 48 Rectal 55 20 Cervix 55 15 1718 789 ALL Non skin Cancer

Recurrence of cancer after RENAL TRANSPLANTATION ANZDATA pre transplant Cancers 1963 - 1999 # Tx – – – – Colon Breast Female genital Prostate Bladder Kidney Ureter Melanoma Lymphoma Myeloma Other non-skin TOTAL No prior Cancer 23 20 20 5 24 37 1 19 10 4 47 210 11684 Recurrence 0 0 2 1 1 2 0 0 3 11

Recurrence of cancer after RENAL TRANSPLANTATION ANZDATA Tx Follow Up Months Dead Dead

ANZDATA Patient survival after Renal Transplantation CD 1 1985 - 1999

Diagnosis of Cancer pre-Transplant Patients at risk = 27, 495 Pt Years at risk = 1, 361, 200

Survival after Diagnosis Cancer diagnosed pre-dialysis 10 8 6 4 2 Median Survival in Years ANZDATA 0

Survival after Diagnosis Cancer diagnosed post-dialysis 10 8 6 4 2 Median Survival in Years ANZDATA 0

Comparison of 5 year survival of general and dialysis populations

Breast Cancer ANZDATA 1999 vs NSW Cancer Databases POPULATIONS 43% 33%

Myeloma ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Colon Cancer ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Bladder Cancer ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Kidney Cancer ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Melanoma ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Lymphoma ANZDATA 1999 vs NSW Cancer Databases POPULATIONS

Lymphoma Bladder Melanoma Colon Kidney Breast

Cancer in Uraemic populations ANZDATA - are the data real? • review of all cases • review causes of death • review metastasis diagnoses • review therapy Acknowledgements: Brian Livingston, Ross Sheil