title: Cancer After Heart Transplantation: A 25-year Single-center Perspective.
abstract: BACKGROUND
  Cancer is a major cause of morbidity and mortality after heart transplantation.
  
  
  METHODS
  We studied 541 heart transplant patients from a single center over a period of 25 years, with a mean follow-up of 10.7 years. We determined incidence, type, risk factors, and prognosis for cancer after heart transplantation.
  
  
  RESULTS
  Cancer was diagnosed in 181 patients, at a mean of 7.7 years after transplantation. Cumulative incidence of cancer at 5, 10, and 20 years was 14%, 29%, and 60%, respectively. The most frequent cancers were spinocellular skin cancer (22%), basocellular skin cancer (19%), lung cancer (16%), lymphoma (11%) and prostate cancer (10%). Age at transplantation > 50 years (hazard ratio, 2.9; P < .001) and male recipient gender (hazard ratio, 1.7; P = .038) were significant risk factors for posttransplant malignancy on multivariate Cox proportional hazards analysis. Median patient survival after diagnosis of cancer was 2.9 years for patients with noncutaneous cancer, versus 13.1 years for patients with only skin cancer (P < .001).
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors: J
authors: J
authors: Van Keer
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors: W
authors: W
authors: Droogné
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors: J
authors: J
authors: Van Cleemput
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors: G
authors: G
authors: Vörös
authors: Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
authors: F
authors: F
authors: Rega
authors: Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
authors: B
authors: B
authors: Meyns
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors: S
authors: S
authors: Janssens
authors: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: johan.vanhaecke@uzleuven.be.
authors: J
authors: J
authors: Vanhaecke
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology; D008223:Lymphoma / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors