title: Liver Transplantation-Associated Lung Cancer: Comparison of Clinical Parameters and Outcomes.
abstract: BACKGROUND
  The incidence of lung cancer (LC) is increased in patients with a history of liver transplantation (LT). The purpose of our study was to compare the clinical characteristics and outcomes of patients with postliver transplantation LC (PLTLC) with cohorts of patients with "transplant-naive" LC, and LT patients without LC.
  
  
  METHODS
  All the patients who had undergone LT or had been diagnosed with LC from 1987 to 2012 were included in the present analysis. The PLTLC cohort was compared with a LT cohort (n = 725) and the local LC registry (n = 2803). The standardized incidence ratios (SIRs) were computed in the classic manner after adjustment for sex, age, and year of follow-up.
  
  
  RESULTS
  Within the LT cohort, 22 patients (5 women) developed PLTLC (2.3%). The SIR for LC in LT recipients was 4.4 in the women and 2.6 in the men. The PLTLC cohort was older at LT (58.4 vs. 53.3 years; P = .028). Also, 90.5% of the PLTLC group had a history of smoking; 8 patients (42.1%) had had LC detected by annual routine lung cancer screening. The median post-LT survival was significantly inferior in the PLTLC cohort (117.1 vs. 182.6 months; P = .041). The median overall survival (OS), starting from the diagnosis of LC, was similar in the PLTLC and LC cohort (14.7 vs. 15.1 months; P = .519).
  
  
  CONCLUSIONS
  The incidence of LC is significantly increased in the LT population. Therefore, LC screening might be an option for LT patients with a history of smoking. The prognosis of LC does not seem to be impaired by LT, suggesting a minor effect of LT on OS in patients with lung cancer.
authors.affiliation: Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria; Tyrolean Cancer Research Institute, Innsbruck, Austria. Electronic address: florian.kocher@i-med.ac.at.
authors.forename: Florian
authors.initials: F
authors.lastname: Kocher
authors.affiliation: Department of Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Armin
authors.initials: A
authors.lastname: Finkenstedt
authors.affiliation: Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
authors.affiliation: Department of Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria; Department of Internal Medicine, District Hospital Hall, Hall, Austria.
authors.forename: Ivo
authors.initials: I
authors.lastname: Graziadei
authors.affiliation: Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Gamerith
authors.affiliation: Department of Clinical Epidemiology of TILAK/Cancer Registry of Tyrol, Innsbruck, Austria.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Oberaigner
authors.affiliation: Department of Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.affiliation: Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hilbe
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D015996:Survival Rate
keywords: Clinical characteristics; Incidence; Liver transplantation; Lung cancer; Survival