Malignancy After Liver Transplantation: Cumulative Risk for Development

Abstract Background Solid organ recipients are at high risk to develop malignancies due to the complex interactions of several factors, constituting a major cause of late death after transplantation. Patients and Methods We retrospectively reviewed an historic cohort of adult liver recipients from c...

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Published in:	Transplantation proceedings Vol. 41; no. 6; pp. 2447 - 2449
Main Authors:	Marqués Medina, E, Jiménez Romero, C, Gómez de la Cámara, A, Rota Bernal, A, Manrique Municio, A, Moreno González, E
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Amsterdam Elsevier Inc 01-07-2009 Elsevier
Subjects:	Adult Biological and medical sciences Confidence Intervals Female Fundamental and applied biological sciences. Psychology Fundamental immunology Humans Kaplan-Meier Estimate Liver Transplantation - adverse effects Liver Transplantation - mortality Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Neoplasms - epidemiology Neoplasms - mortality Retrospective Studies Risk Factors Sex Characteristics Skin Neoplasms - epidemiology Skin Neoplasms - mortality Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Analysis Tissue, organ and graft immunology Digestive system Liver Risk Malignancy Malignant tumor Homotransplantation Medicine Treatment Surgery Risk factor Development Graft Cancer Liver transplantation
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Summary:	Abstract Background Solid organ recipients are at high risk to develop malignancies due to the complex interactions of several factors, constituting a major cause of late death after transplantation. Patients and Methods We retrospectively reviewed an historic cohort of adult liver recipients from cadaveric donors (multiorgan recipients excluded) performed from 1986–2002 with a minimum follow-up of 36 months. The Kaplan-Meier method was used to assess cumulative risk to develop malignancy and survival analyses. Results Among the 528 patients undergoing orthotopic liver transplantation (OLT) with a mean follow-up of 2400 days, 98 developed cancer among which 25% were skin malignancies. Sixty-seven patients developed at least 1 noncutaneous malignancy, an overall incidence of 12.7%. Eighteen percent suffered from posttransplant lymphoproliferative disease; 14%, lung cancer; 4%, Kaposi's sarcoma; 7%, genitourinary malignancies; and 17%, oropharyngeal or laryngeal cancer. The cumulative patient risks to develop noncutaneous malignancies at 5, 10, and 15 years posttransplantation were 9% (confidence interval [CI]: 0.06–0.11), 18% (CI: 0.14–0.23), and 25% (CI: 0.18–0.31), respectively. Conclusions OLT recipients are at higher risk to develop malignancies after transplantation, reaching a cumulative risk of 25% at 15 years. Long-term surveillance measures and screening programs must be seriously conducted for selected groups.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0041-1345 1873-2623
DOI:	10.1016/j.transproceed.2009.06.153