title: Head and neck and esophageal cancers after liver transplant: results from a multicenter cohort study. Italy, 1997-2010.
abstract: This study quantified the risk of head and neck (HN) and esophageal cancers in 2770 Italian liver transplant (LT) recipients. A total of 186 post-transplant cancers were diagnosed-including 32 cases of HN cancers and nine cases of esophageal carcinoma. The 10-year cumulative risk for HN and esophageal carcinoma was 2.59%. Overall, HN cancers were nearly fivefold more frequent in LT recipients than expected (standardized incidence ratios - SIR=4.7, 95% CI: 3.2-6.6), while esophageal carcinoma was ninefold more frequent (SIR=9.1, 95% CI: 4.1-17.2). SIRs ranged from 11.8 in LT with alcoholic liver disease (ALD) to 1.8 for LT without ALD for HN cancers, and from 23.7 to 2.9, respectively, for esophageal carcinoma. Particularly elevated SIRs in LT with ALD were noted for carcinomas of tongue (23.0) or larynx (13.7). Our findings confirmed and quantified the large cancer excess risk in LT recipients with ALD. The risk magnitude and the prevalence of ALD herein documented stress the need of timely and specifically organized programs for the early diagnosis of cancer among LT recipients, particularly for high-risk recipients like those with ALD.
authors.affiliation: Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Pierluca
authors.initials: P
authors.lastname: Piselli
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.affiliation: Liver and Multiorgan Transplant Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Lauro
authors.affiliation: Liver Transplant Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Baccarani
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy.
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Ettorre
authors.affiliation: Department of Gastroenterology and Hepatology, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Palermo, Italy.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Vizzini
authors.affiliation: Department of Emergency and Organ Transplantation, Section of Gastroenterology, University Hospital, Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Rendina
authors.affiliation: Department of General Surgery and Organ Transplantation, Umberto I Policlinic, Sapienza University, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rossi
authors.affiliation: UOC Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
authors.affiliation: Department of Surgery, General and Hepatic Transplantation Surgery Unit, A.O.B. Brotzu, Cagliari, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Zamboni
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bortoluzzi
authors.affiliation: Liver and Multiorgan Transplant Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.
authors.forename: Antonio D
authors.initials: AD
authors.lastname: Pinna
authors.affiliation: Liver Transplant Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
authors.affiliation: Department of Gastroenterology and Hepatology, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), University of Pittsburgh Medical Center, Palermo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Galatioto
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.affiliation: Department of Emergency and Organ Transplantation, Section of Gastroenterology, University Hospital, Bari, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Di Leo
authors.affiliation: Department of General Surgery and Organ Transplantation, Umberto I Policlinic, Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Nudo
authors.affiliation: UOC Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Sforza
authors.affiliation: Department of Surgery, General and Hepatic Transplantation Surgery Unit, A.O.B. Brotzu, Cagliari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fantola
authors.affiliation: Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cimaglia
authors.affiliation: Department of Epidemiology and Pre-Clinical Research, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Verdirosi
authors.affiliation: Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Pordenone, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Virdone
authors.affiliation: Epidemiology and Biostatistics Unit, Centro di Riferimento Oncologico IRCCS, Aviano, Pordenone, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Serraino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007558:Italy; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors
keywords: aerodigestive cancers; cancer risk; immunosuppression; liver cirrhosis; liver diseases; oncogenic viruses; organ transplantation