The Prognosis of Urothelial Carcinoma Between Kidney Transplantation Recipients and Normal Patients: A Propensity Score‐Matched Study

ABSTRACT Objective To evaluate the difference in the characteristics and prognosis between kidney transplantation (KT) recipients and normal patients with urothelial carcinoma. Method We retrospectively reviewed the characteristics of the kidney‐transplanted patients and the general patients who were diagnosed with urothelial carcinoma between 2013 and 2021. The non‐kidney transplantation (NKT) group is matched with the KT group through propensity score matching (PSM) to adjust for confounders. We evaluated the prognosis including overall survival (OS), relapse‐free survival (RFS), and progression‐free survival (PFS). We compared the difference in the prognosis between the two groups using Kaplan–Meier analysis and the log‐rank test. Result The characteristics of 344 NKT patients and 42 KT recipients with urothelial carcinoma were included in this research. The percentage of females was significantly higher in the KT group than in the NKT group ( p  < 0.001). Tumors mostly occurred in the upper tract in the KT group and in the bladder cancer (BC) in the NKT group. After propensity score matching (PSM), overall survival (OS) was significantly longer in the KT group with upper tract urothelial carcinoma (UTUC) than in the NKT group ( p  = 0.001), whereas recurrence‐free survival and progression‐free survival (PFS) were significantly lower in the KT group with UTUC+BC than in the NKT group ( p  = 0.028, 0.044). Conclusion Patients with tumors that occur in both the bladder and upper urinary tract have a worse prognosis. Kidney transplantation recipients with only bladder or upper urinary tract UC have a prognosis that is no worse or even better than that of NKT patients.