Comparative Incidence of De Novo Nonlymphoid Malignancies After Liver Transplantation Under Tacrolimus Using Surveillance Epidemiologic End Result Data1

Abstract

An increased incidence of de novo cancers in the chronically immunocompromised patient demands careful long-term screening protocols which will help to facilitate the diagnosis at an early stage of the disease. This is particularly true for oropharyngeal cancers where the risk is more than 7 times higher compared to SEER incidence data matched for age, sex, and length of follow-up.

Evolution and management of de novo neoplasm post-liver transplantation: a 20-year experience from a single European centre

“…Differences in latitude and sun exposure and immunosuppressive protocols may explain these differences. We found no mortality in these patients, thus confirming the low mortality observed by other authors [9,17,23,24]. In our outpatient clinic, dermatological evaluations are made in all patients so that these lesions can be diagnosed and treated.…”

Unresectable Squamous Cell Carcinoma of Donor Origin Treated With Immunosuppression Withdrawal and Liver Retransplantation

“…In our experience, other nonlymphoid solid organ tumors are not known to occur with increased frequency following liver transplantation (4). Others, however, have reported an increased incidence of oropharyngeal and respiratory tract malignancies (22), as well as renal cell and colon carcinomas (23). Although historically difficult to verify, a number of tumors of donor origin have been reported to be transmitted with allografts to recipients of solid organ transplants.…”

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

“…For example, some authors prefer to include posttransplant lymphoproliferative disorders (PTLDs) along with de novo solid cancers, [22][23][24][25][26][27][28][29][30] whereas others prefer not to include them. 15,18,31,32 This has caused a major discrepancy in reported rates of de novo cancers. Nonmelanoma, non-Kaposi's skin cancers (squamous cell cancer and basal cell carcinoma) are the commonest types of de novo malignancies in the posttransplant population, with an up to 70 times higher incidence in comparison with nontransplant populations.…”

“…The study population of 1000 consecutive post-LTx patients using tacrolimus from the University of Pittsburgh was first examined in August 1999 for de novo cancers with a mean follow-up of 77.8 Ϯ 11.1 months (4795.3 total person years). 32 There were 57 cases of de novo cancers in all (lymphoid lesions excluded), which included 22 nonmelanoma, nonKaposi's skin cancers. This incidence increased when the longitudinal follow-up was extended to 8199 person years in December 2002.…”

“…However, the incidence does not appear to be higher in the post-LTx population. 17,18,22,23,26,32,33 Haagsma and coworkers 24 from the Netherlands reported a 30-fold increase in de novo cancers of the kidney. Also, in a large Swedish post-kidney and liver transplant population study of 5931 cases, SIR for kidney cancer was 4.9 times higher.…”