Long-term results of lung cancer after heart transplantation: single center 20-year experience.
OBJECTIVE
The present study analyses, long-term lung cancer survival rate in the Niguarda heart transplant population and the results of surgical treatments.


METHODS
From November 1985 to December 2006, 786 heart transplants were performed in our Center; we underwent a retrospective review of patients developing primary lung cancer.


RESULTS
Among 660 heart transplant recipients valuable in this study, 22 (3.3%) developed a primary lung cancer (20 male, 91%), their mean age at time of heart transplant was 54.5+/-5.2 years (range, 42-65). The mean time from transplantation to lung cancer diagnosis was 73.7+/-30 months. Eleven patients (50%) were in stage IIIB or higher at the time of presentation. The 5-year survival rate of the entire study population was 21.4%, with a median survival time (MST) of 10.1 months. Ten patients underwent surgical resection (9 lobectomies and 1 wedge resection) and demonstrated improved long-term survival with 5-year survival of 56% and MST 70.4 months, compared to patients who did not undergo any surgical procedure, all of whom died during follow-up, with 1-year survival of 33%.


CONCLUSIONS
Long-term results following lung cancer surgery in heart transplant recipients are satisfactory when performed at the early stage of the disease. Preventive computed tomography screen should be considered as a routine method for early diagnosis in this group of high-risk patients.
Division of Cardiac Surgery, Department A. De Gasperis, Niguarda Ca' Granda Hospital, Milan, Italy. giuseppe.bruschi@fastwebnet.it
Giuseppe
G
Bruschi
Serena
S
Conforti
Massimo
M
Torre
Tiziano
T
Colombo
Claudio F
CF
Russo
Giovanna
G
Pedrazzini
Maria
M
Frigerio
Mario
M
Ravini
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012306:Risk; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D007166:Immunosuppressive Agents