De novo tumors are a major cause of late mortality after orthotopic liver transplantation.
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.
Baccarani
U
U
Department of Tissue & Organ Transplantation, University Hospital of Udine, Udine, Italy. umberto.baccarani@uniud.it
Adani
G L
GL
Serraino
D
D
Lorenzin
D
D
Gambato
M
M
Buda
A
A
Zanus
G
G
Vitale
A
A
Piselli
P
P
De Paoli
A
A
Bresadola
V
V
Risaliti
A
A
Toniutto
P
P
Cillo
U
U
Bresadola
F
F
Burra
P
P
D006801:Humans; D016031:Liver Transplantation; D009369:Neoplasms / Q000209:etiology*; D015996:Survival Rate