title: Post-transplant malignancy in liver transplantation: a single center experience.
abstract: We aim to determine the incidence of malignancy after liver transplantation (LT) compared to general population. The records of patients who received LTs at our center from October 1989 and November 2012 were retrospectively reviewed. The standardized incidence ratio (SIR) of cancer in the patients was compared to general population using the data from the Taiwan Cancer Registry. Survival was estimated using the Kaplan-Meier method. A total of 444 patients were included. Malignancy was found in 46 (28 de novo and 19 recurrent malignancies) patients (10.4%) with the median follow up of 4.2±4.2 years. The median time of cancer occurrence after transplant was 1.2±1.9 years (range, 0.2-9.1 years). Post-transplant lymphoproliferative disorder was the most frequent de novo malignancy (57.1% [16/28]). The cumulative incidence rates of all malignancies were 5.1%, 10.4%, 12.8%, 15.8%, and 15.8% at 1, 3, 5, 10, and 15 years, respectively. The cumulative incidence rates of de novo malignancies were 3.4%, 5.97%, 7.7%, 10.9%, and 10.9 % at 1, 3, 5, 10, and 15 years. Compared to general population, transplant recipients had significantly higher incidence of all de novo cancers (SIR: 3.26, 95% confidence interval [CI]: 2.17-4.72), hematologic (SIR: 58.4; 95% CI, 33.3-94.8), and bladder (SIR: 10.2, 95% CI: 1.1-36.7) cancers. The estimated mean survivals after transplantation in cancer-free, de novo cancer, and recurrent cancer patients were 17.7±0.5, 11.3±1.2, and 3.6±0.6 years, respectively. There is a significantly increased risk of malignancies after LT in the Taiwanese population.
authors.affiliation: From the Department of Surgery (CYH, PHL, CMH, YMW, MCH, RHH) and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (PHL, CMH).
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Hsiao
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Cheng-Maw
authors.initials: CM
authors.lastname: Ho
authors.forename: Yao-Ming
authors.initials: YM
authors.lastname: Wu
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Ho
authors.forename: Rey-Heng
authors.initials: RH
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult