A 30-Year Analysis of Colorectal Adenocarcinoma in Transplant Recipients and Proposal for Altered Screening

Johnson, Erik E.; Leverson, Glen; Pirsch, John D.; Heise, Charles P.

doi:10.1007/s11605-007-0084-4

Cited by 73 publications

(81 citation statements)

References 29 publications

(49 reference statements)

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“…By hand searching, another 20 articles were identified. When the exclusion criteria were applied, the final 29 studies were included for review ( Figure 1) (2,6,16,36,37,40) were of high, 15 of medium (3,35,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)) and 8 of low quality according to the DQS (38,39,(54)(55)(56)(57)(58)(59). A pretransplantation screening protocol for LTx evaluation was mentioned in 2 studies (16,37 (3,6,37,40,45,52,53).…”

Section: Study Selectionmentioning

confidence: 99%

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Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Nicolaas

Jonge²,

Steyerberg

et al. 2010

American Journal of Transplantation

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Liver transplant patients (LTx) have an increased risk for developing de novo malignancies, but for colorectal cancer (CRC) this risk is less clear. We aimed to determine whether the CRC risk post-LTx was increased. A systematic search was performed in MEDLINE and Cochrane databases to identify studies published between 1986 and 2008 reporting on the risk of CRC postLTx. The outcomes were (1) CRC incidence rate (IR per 100 000 person-years (PY)) compared to a weighted age-matched control population using SEER and (2) relative risk (RR) for CRC compared to the general population. If no RR data were available, the RR was estimated using SEER. Twenty-nine studies were included. The overall post-LTx IR was 119 (95% CI 88-161) per 100 000 PY. The overall RR was 2.6 (95% CI 1.7-4.1). The non-primary sclerosing cholangitis (PSC) IR was 129 per 100 000 PY (95% CI 81-207). Compared to SEER (71 per 100 000 PY), the non-PSC RR was 1.8 (95% CI 1.1-2.9). In conclusion, the overall transplants and the subgroup non-PSC transplants have an increased CRC risk compared to the general population. However, in contrast to PSC, non-PSC transplants do not need an intensified screening strategy compared to the general population until a prospective study further defines recommendations.

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Section: Study Selectionmentioning

confidence: 99%

“…After pooling the 10 studies (Figure 4) (2,6,16,37,40,45,49,52,53) (48,65,66 (6,37). One of these two studies reported a mean age of LTx of 56 years (37).…”

Section: Risk Of Crc In Post-ltx Patients: a Meta-analysis Of Follow-mentioning

confidence: 99%

Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Nicolaas

Jonge²,

Steyerberg

et al. 2010

American Journal of Transplantation

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“…Although some studies have identified an increased risk of colorectal neoplasia among these patients (3)(4)(5)(6), the topic remains controversial. (13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

“…CMV nucleic acids and proteins specifically localized to neoplastic cells in human colorectal polyps and adenocarcinomas have been reported (18). Exclusion criteria were as follows: (1) unwillingness to participate (N = 398), (2) (4) intolerance of cleansing solution intake for colon preparation (N = 25), (5) history of colorectal neoplasia (N = 5) and (6) The results of logistic regression analysis adjusted for age and gender are shown in Table 4.…”

Section: Introductionmentioning

confidence: 99%

Increased Incidence of Colorectal Malignancies in Renal Transplant Recipients: A Case Control Study

Park¹,

Choi²,

Kim³

et al. 2010

American Journal of Transplantation

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This study was to evaluate the frequency of colorectal neoplasia in renal transplant recipients and to investigate the association with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection. We compared the frequency of colorectal neoplasia among renal transplant recipients with that of the healthy subjects. Specimens of colorectal neoplasia were examined for EBV and CMV using in situ hybridization and immunohistochemistry, respectively. Of 796 renal transplantation cohorts, 315 were enrolled. The frequency of colorectal neoplasia among the patients was 22.9%. Compared with the healthy subjects, the odds ratio (OR) for advanced adenoma was 3.32 (95% CI, 1.81-6.10). The frequency of cancer among the patients was 1.9% (OR, 12.0; 95% CI, 1.45-99.7). A long interval between transplantation and colonoscopy was a significant factor in the development of advanced colorectal neoplasia. EBV positivity was detected in 30.6% of colorectal neoplasia specimens from renal transplant recipients, which was higher than that for the controls (p = 0.002). CMV was not detected in any lesions of patients or controls. In conclusion, renal transplant recipients have a significantly increased risk of advanced colorectal neoplasia. EBV was more frequently found in specimens of advanced colorectal neoplasm obtained from the renal transplant recipients.

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“…However, the age still tended to be less than that in CRC in the general population, since one-year CRC prevalence showed a peak in 65 -74 years of males and in over 75 years of females in Japan (33). Another report has demonstrated that transplant recipients under the age of 50 have a 10-fold greater risk of developing CRC (34). On the basis of this result, it has been …”

Section: Discussionmentioning

confidence: 98%

Six Cases of Primary Colorectal Cancer After Living-donor Liver Transplantation: A Single-institution Experience in Japan

Kazama

Hongo

Sunami

et al. 2012

Japanese Journal of Clinical Oncology

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Objective: Liver-transplant patients have an increased risk of developing primary malignancies, possibly due to prolonged immunosuppression. However, no information on the incidence and biological characteristics of colorectal cancer after living-donor liver transplantation is available. Methods: The medical records of 392 consecutive adult patients who had undergone livingdonor liver transplantation were retrospectively analyzed. Results: Colorectal cancer developed in 6 (1.5%) patients; 3 of 204 (1.5%) presented with hepatic cirrhosis, 2 of 77 (2.5%) with primary biliary cirrhosis and 1 (2.6%) of 39 with subacute fulminant hepatitis, but none of 13 patients with primary sclerosing cholangitis. Four patients were successfully treated with curative surgery and one with endoscopic resection, while another patient died 3 months after palliative surgery because of the progression of peritoneal metastasis. A pathological study revealed vessel invasion in all the five cases of surgically removed colorectal cancer and nodal metastasis in four (80%) cases. Conclusions: Colorectal cancer develops at a relatively high frequency after living-donor liver transplantation, even in non-primary sclerosing cholangitis cases, and might have high malignant potential. The screening program for colorectal cancer should be more intensified after living-donor liver transplantation compared with that in the general population.

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A 30-Year Analysis of Colorectal Adenocarcinoma in Transplant Recipients and Proposal for Altered Screening

Cited by 73 publications

References 29 publications

Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Increased Incidence of Colorectal Malignancies in Renal Transplant Recipients: A Case Control Study

Six Cases of Primary Colorectal Cancer After Living-donor Liver Transplantation: A Single-institution Experience in Japan

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