title: De novo tumors are a major cause of late mortality after orthotopic liver transplantation.
abstract: The purpose of this study was to describe de novo post-orthotopic liver transplantation (OLT) malignancies for comparison with incidence rates in Italian cancer registries. Three hundred thirteen OLT patients engrafted from 1991 to 2006 and surviving 12 months without a previous diagnosis of cancer were evaluated for the development of de novo malignancies excluding nonmelanoma skin cancers. During a total follow-up time of 1753 PYs, 40 (12.8%) de novo malignancies were diagnosed in 40 recipients. The most common cancers were non-Hodgkin lymphoma (NHL; 20%), cancer of the head and neck (17%), Kaposi sarcoma (KS; 17%), and esophageal tumors (12%). The 1-, 3-, 5-, and 10-year estimated survival rates were 70%, 56%, 48%, and 39%. Patients with de novo cancers showed a lower 10-years survival rate (P = .0047) than patients without (39% vs 75%). The risk of cancer after OLT was 3-fold higher than that of the general population of the same age and gender (95% confidence interval [CI], 2.0-4.3). De novo tumor sites or types with significantly elevated standardized incidence ratios (SIRs) included KS (SIRs = 212), NHL (SIRs = 13.7), oesophagus (SIRs = 18.7), melanoma (SIRs = 10.1), and head and neck cancers (SIRs = 4.6). Tumors after OLT were associated with lower long-term survival, confirming that cancer is a major cause of late mortality.
authors.affiliation: Department of Tissue & Organ Transplantation, University Hospital of Udine, Udine, Italy. umberto.baccarani@uniud.it
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: G L
authors.initials: GL
authors.lastname: Adani
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: D
authors.initials: D
authors.lastname: Lorenzin
authors.forename: M
authors.initials: M
authors.lastname: Gambato
authors.forename: A
authors.initials: A
authors.lastname: Buda
authors.forename: G
authors.initials: G
authors.lastname: Zanus
authors.forename: A
authors.initials: A
authors.lastname: Vitale
authors.forename: P
authors.initials: P
authors.lastname: Piselli
authors.forename: A
authors.initials: A
authors.lastname: De Paoli
authors.forename: V
authors.initials: V
authors.lastname: Bresadola
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
authors.forename: P
authors.initials: P
authors.lastname: Toniutto
authors.forename: U
authors.initials: U
authors.lastname: Cillo
authors.forename: F
authors.initials: F
authors.lastname: Bresadola
authors.forename: P
authors.initials: P
authors.lastname: Burra
mesh_terms: D006801:Humans; D016031:Liver Transplantation; D009369:Neoplasms / Q000209:etiology*; D015996:Survival Rate