This study assessed the impact of cancer on the risk of death with a functioning graft of kidney transplant (KT) recipients, as compared to corresponding recipients without cancer. A matched cohort study was conducted using data from a cohort of 13 245 individuals who had undergone KT in 17 Italian centers (1997–2017). Cases were defined as subjects diagnosed with any cancer after KT. For each case, two controls matched by gender, age, and year at KT were randomly selected from cohort members who were cancer-free at the time of diagnosis of the index case. Overall, 292 (20.5%) deaths with a functioning graft were recorded among 1425 cases and 238 (8.4%) among 2850 controls. KT recipients with cancer had a greater risk of death with a functioning graft (hazard ratio, HR = 3.31) than their respective controls. This pattern was consistent over a broad range of cancer types, including non-Hodgkin lymphoma (HR = 33.09), lung (HR = 20.51), breast (HR = 8.80), colon-rectum (HR = 3.51), and kidney (HR = 2.38). The survival gap was observed throughout the entire follow-up period, though the effect was more marked within 1 year from cancer diagnosis. These results call for close posttransplant surveillance to detect cancers at earlier stages when treatments are more effective in improving survival.

中文翻译：

---

癌症对意大利肾移植受者功能移植物死亡风险的影响

这项研究评估了癌症对功能移植肾移植 (KT) 受者死亡风险的影响，并与相应的未患癌症的受者进行了比较。使用来自 17 个意大利中心（1997-2017 年）接受过 KT 的 13245 名个体的队列数据进行了一项匹配队列研究。病例被定义为在 KT 后被诊断患有任何癌症的受试者。对于每个病例，从指示病例诊断时未患癌症的队列成员中随机选择两名按性别、年龄和在 KT 的年份匹配的对照。总体而言，在 1425 例病例中记录了 292 例 (20.5%) 死亡且移植物功能正常，在 2850 例对照中记录了 238 例 (8.4%)。与各自的对照组相比，患有癌症的 KT 接受者因移植物功能正常而死亡的风险更高（风险比，HR = 3.31）。这种模式在广泛的癌症类型中是一致的，包括非霍奇金淋巴瘤 (HR = 33.09)、肺癌 (HR = 20.51)、乳腺癌 (HR = 8.80)、结肠-直肠癌 (HR = 3.51) 和肾脏 (HR = 2.38）。在整个随访期间观察到生存差距，尽管在癌症诊断后的 1 年内效果更为显着。这些结果要求进行密切的移植后监测，以便在治疗更有效地提高生存率的早期阶段检测癌症。