title: Six cases of primary colorectal cancer after living-donor liver transplantation: a single-institution experience in Japan.
abstract: OBJECTIVE
  Liver-transplant patients have an increased risk of developing primary malignancies, possibly due to prolonged immunosuppression. However, no information on the incidence and biological characteristics of colorectal cancer after living-donor liver transplantation is available.
  
  
  METHODS
  The medical records of 392 consecutive adult patients who had undergone living-donor liver transplantation were retrospectively analyzed.
  
  
  RESULTS
  Colorectal cancer developed in 6 (1.5%) patients; 3 of 204 (1.5%) presented with hepatic cirrhosis, 2 of 77 (2.5%) with primary biliary cirrhosis and 1 (2.6%) of 39 with subacute fulminant hepatitis, but none of 13 patients with primary sclerosing cholangitis. Four patients were successfully treated with curative surgery and one with endoscopic resection, while another patient died 3 months after palliative surgery because of the progression of peritoneal metastasis. A pathological study revealed vessel invasion in all the five cases of surgically removed colorectal cancer and nodal metastasis in four (80%) cases.
  
  
  CONCLUSIONS
  Colorectal cancer develops at a relatively high frequency after living-donor liver transplantation, even in non-primary sclerosing cholangitis cases, and might have high malignant potential. The screening program for colorectal cancer should be more intensified after living-donor liver transplantation compared with that in the general population.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kaz-tky@umin.ac.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kazama
authors.forename: Kumiko
authors.initials: K
authors.lastname: Hongo
authors.forename: Eiji
authors.initials: E
authors.lastname: Sunami
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D019520:Living Donors; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents