De novo malignancy after lung transplantation in Japan.
OBJECTIVE
Lung transplant recipients have an increased de novo cancer risk due to long-term immunosuppression and several oncogenic viral infections. In Japan, to date, there have been no national surveys of the incidence of de novo malignancy after lung transplantation.


METHODS
This national survey was conducted by the Japanese Society for Transplantation. The questionnaire was distributed to lung transplant institutions, asking about several clinical factors related to de novo malignancy patients transplanted from 2001 to 2010.


RESULTS
179 cases of lung transplantation were performed by seven institutions in Japan between 2001 and 2010. De novo malignancies occurred in 18 patients (10.1 %). The most common malignancy was a lymphoproliferative malignancy (12 cases, including 1 double de novo cancer after tongue cancer), followed by cervical cancer (4 cases), breast cancer (2 cases), and tongue cancer (1 case). The mean time of occurrence after transplantation was 37.8 (range 4-148) months. Reduction and/or withdrawal of immunosuppression for the treatment of malignancy was seen in 14 cases. Death due to cancer occurred in 6 cases. The overall 5-year survival of 18 patients was 58.9 %. The 5-year survival of post-transplant lymphoproliferative disorder was not significantly different from that of other malignancies (47.6 and 62.5 %, respectively; p = 0.33).


CONCLUSIONS
This is the first national survey of the incidence of de novo malignancy after lung transplantation in Japan. The incidence was 10.1 % and post-transplant lymphoproliferative disorder was the most common malignancy.
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. miyataku@nagasaki-u.ac.jp.
Takuro
T
Miyazaki
Department of Organ Transplant Center, Okayama University Graduate School of Medicine, Okayama, Japan.
Takahiro
T
Oto
Department of General Thoracic Surgery, Osaka University, Suita, Japan.
Meinoshin
M
Okumura
Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.
Hiroshi
H
Date
Department of General Thoracic, Breast, and Pediatric Surgery, Fukuoka University, Fukuoka, Japan.
Takeshi
T
Shiraishi
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Yoshinori
Y
Okada
Department of Thoracic Surgery, Dokkyo Medical University, Mibu, Japan.
Masayuki
M
Chida
Tohoku Pharmaceutical University Hospital, Sendai, Japan.
Takashi
T
Kondo
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Takeshi
T
Nagayasu
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016040:Lung Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents
De novo malignancy; Immunosuppression; Lung transplantation