Malignancy After Liver Transplantation: Cumulative Risk for Development

• 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
• DOI: 10.1016/j.transproceed.2009.06.153
• EISSN: 1873-2623
• ISSN: 0041-1345

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.