title: De novo malignancies following liver transplantation: results from a multicentric study in central and southern Italy, 1990-2008.
abstract: OBJECTIVE
  The objective of this study was to quantify incidence rates (IR) and risks of de novo tumors (except nonmelanoma skin cancers) in patients who underwent orthotopic liver transplantation (OLT) in central and southern Italy.
  
  
  METHODS
  Data were collected on 1675 patients (75.5% males) who underwent OLT in six Italian transplantation centers in central and southern Italy (1990-2008). The time at risk of cancer (person years [PY]) was computed from OLT to the date of cancer diagnosis, death, or last follow-up, whichever occurred first. The number of observed cancer cases were compared with the expected one using data from population-based cancer registries. We computed gender- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  During 10,104.3 PYs (median follow-up, 5.2 years), 98 patients (5.9% of the total) were diagnosed with a de novo malignancy (for a total of 100 diagnoses). Twenty-two of these cancers were post-transplantation lymphoproliferative disorders (PTLD; 18 non-Hodgkin lymphoma [NHL] and 2 Hodgkin's lymphoma [HL]), 6 were Kaposi's sarcoma (KS), and 72 were solid tumors (19 head and neck [H&N], 13 lung, 11 colon-rectum, 6 bladder, and 4 melanoma). The overall incidence was 9.9 cases/10(3) PYs, with a 1.4-fold significantly increased SIR (95% CI, l.2-1.7). Significantly increased SIRs were observed for KS (37.3), PTLD (3.9), larynx (5.7), melanoma (3.1), tongue (7.1), and H&N (4.5) cancers.
  
  
  CONCLUSIONS
  These results confirmed that OLT patients are at greater risk for cancer, mainly malignancies either virus-associated or related to pre-existent factors (eg, alcohols). These observations point to the need to improve cancer surveillance after OLT. The on-going enrollment of patients in the present cohort study will help to elucidate the burden of cancer after OLT and better identify risk factors associated with its development.
authors.affiliation: POIT "S.Camillo-Spallanzani", Rome, Itlay.
authors.forename: G M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: P
authors.initials: P
authors.lastname: Piselli
authors.forename: L
authors.initials: L
authors.lastname: Galatioto
authors.forename: M
authors.initials: M
authors.lastname: Rendina
authors.forename: F
authors.initials: F
authors.lastname: Nudo
authors.forename: D
authors.initials: D
authors.lastname: Sforza
authors.forename: L
authors.initials: L
authors.lastname: Miglioresi
authors.forename: G
authors.initials: G
authors.lastname: Fantola
authors.forename: C
authors.initials: C
authors.lastname: Cimaglia
authors.forename: G
authors.initials: G
authors.lastname: Vennarecci
authors.forename: G B
authors.initials: GB
authors.lastname: Vizzini
authors.forename: A
authors.initials: A
authors.lastname: Di Leo
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Tisone
authors.forename: F
authors.initials: F
authors.lastname: Zamboni
authors.forename: R
authors.initials: R
authors.lastname: Santoro
authors.forename: A
authors.initials: A
authors.lastname: Agresta
authors.forename: V
authors.initials: V
authors.lastname: Puro
authors.forename: D
authors.initials: D
authors.lastname: Serraino
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D007558:Italy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012189:Retrospective Studies