title: Comparison of de novo tumours after liver transplantation with incidence rates from Italian cancer registries.
abstract: OBJECTIVE
  The purpose of this study is to describe de novo post-liver transplant malignancies and compare their frequency with incidence rates from Italian cancer registries.
  
  
  METHODS
  Four hundred and seventeen patients subjected to liver transplantation, from 1991 to 2005, surviving for at least 30 days and without a previous diagnosis of cancer (including hepatocellular carcinoma), were evaluated for the development of de novo malignancies excluding non-melanoma skin cancers.
  
  
  RESULTS
  During a total follow-up time of 2856 person-years, 43 de novo malignancies were diagnosed in 43 liver transplantation recipients (10.3%). The most common cancers were non-Hodgkin lymphoma (9 cases), cancer of the head and neck (8 cases), Kaposi's sarcoma (6 cases) and esophageal carcinoma (5 cases). The 1, 3, 5 and 10 years estimated survival rates were 69%, 57%, 53% and 42%. Patients with de novo cancers had a lower 10-year survival rate than patients without cancers (58% versus 76%, p=0.005). The risk of cancer after liver transplantation was nearly 3-fold higher than that of the general population of the same age and sex (95% CI: 1.9-3.6). De novo tumour sites or types with significantly elevated SIR included Kaposi's sarcoma (SIR=144), non-Hodgkin lymphoma (SIR=13.8), esophagus (SIR=23.4), head and neck cancers (SIR=7) and cervix uteri (SIR=30.7).
  
  
  CONCLUSIONS
  Tumours after liver transplantation are associated with lower long-term survival, confirming that cancer is a major cause of late mortality in liver transplantation.
authors.affiliation: Department of Tissue & Organ Transplantation, University Hospital of Udine, Italy. umberto.baccarani@uniud.it
authors.forename: U
authors.initials: U
authors.lastname: Baccarani
authors.forename: P
authors.initials: P
authors.lastname: Piselli
authors.forename: D
authors.initials: D
authors.lastname: Serraino
authors.forename: G L
authors.initials: GL
authors.lastname: Adani
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: A
authors.initials: A
authors.lastname: De Paoli
authors.forename: C
authors.initials: C
authors.lastname: Cimaglia
authors.forename: V
authors.initials: V
authors.lastname: Bresadola
authors.forename: P
authors.initials: P
authors.lastname: Toniutto
authors.forename: A
authors.initials: A
authors.lastname: Risaliti
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: D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012306:Risk; D016019:Survival Analysis