Increased cancer risk after liver transplantation: a population-based study.
OBJECTIVE
Development of de novo malignancies emerges as a serious long term complication after liver transplantation.


METHODS
We reviewed the medical records of 174 adult one-year survivors for de novo malignancies. The observed cancer rates were compared with the expected cancer rates in the Dutch population.


RESULTS
Twenty-one of the 174 patients developed 23 malignancies (12%). Skin and lip cancer accounted for 12 of the 23 malignancies (52%). Only one patient had a B-cell lymphoma. The cumulative risk for de novo malignancy was 6, 20, and 55% at 5, 10, and 15 years after transplantation, respectively. The overall relative risk (RR) as compared with the general population was 4.3 (95% confidence interval 2.4-7.1). Significantly increased RRs were observed for non-melanoma skin cancer (RR 70.0), non-skin solid cancer (RR 2.7), renal cell cancer (RR 30.0), and colon cancer (RR 12.5). Multivariate analysis showed that an age > 40 years and pretransplant use of immunosuppression were significant risk factors.


CONCLUSIONS
An increased risk of cancer exists after liver transplantation, for both for skin/lip cancer, and other solid tumors. Older age and the use of immunosuppression are risk factors.
Haagsma
E B
EB
Department of Gastroenterology and Hepatology, University Hospital Groningen, The Netherlands. e.b.haagsma@int.azg.nl
Hagens
V E
VE
Schaapveld
M
M
van den Berg
A P
AP
de Vries
E G
EG
Klompmaker
I J
IJ
Slooff
M J
MJ
Jansen
P L
PL
D000328:Adult; D000367:Age Factors; D003110:Colonic Neoplasms / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007680:Kidney Neoplasms / Q000209:etiology; D008048:Lip Neoplasms / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology
D007166:Immunosuppressive Agents