Sirolimus use improves cancer-free survival following transplantation: a single center 12-year analysis

•We aimed to determine whether Sirolimus use is associated with improved cancer-free survival following renal transplantation.•563 kidney transplant recipients were maintained on Sirolimus, tacrolimus [Tac], and mycophenolate mofetil [MMF].•We compared cancer-related outcomes with that of our 65 historical controls maintained on Tac, MMF and steroids.•Patients maintained on chronic immunosuppression with sirolimus developed statistically-significant lower levels of PTLD.•Cancer-free survival as well as cancer-free mortality were also improved 10–12 years post-transplant.•Sirolimus-based regimens improve long-term cancer-free survival while maintaining equivalent patient and graft survival.