De novo malignancy post–liver transplantation: a single center, population controlled study

Abstract

Background With the growing numbers of liver transplant recipients, it is increasingly important to understand the risks of de novo malignancy after liver transplantation. Aim To characterize the incidence of de novo malignancy after liver transplantation compared to a control non-transplant population. Methods We studied 534 Indiana state residents undergoing liver transplantation at our center between 1997 and 2004, followed through August 2010 The incidence and predictors of malignancy were determined. The standardized incidence ratio (SIR) of cancer in our cohort was compared to age, gender and period matched state population using the Indiana State Cancer Registry. Results After a mean follow up of 5.7 ± 3.2 years, 73 patients (13.7%) developed 80 cancers, with 5 and 10 year incidence rates of 11.7%, and 24.8%, respectively. These included 24 (30%) skin, 16 (20%) hematologic and 40 (50%) solid tumors. The most common solid cancers were aerodigestive. Compared to matched state population, liver transplant recipients had significantly higher incidence of all cancers (SIR:3.1, 95%CI:2.9–3.2), skin (melanoma) (SIR:5.8, 95%CI:4.7–7.0), hematologic (SIR:7.1, 95%CI:6.3–8.0), and solid (SIR:2.7, 95%CI:2.5–2.8) tumors. Conclusion There is a significantly increased risk of de novo malignancies after liver transplantation, highlighting the need for surveillance strategies in this population.

Progression of Incidental Intraductal Papillary Mucinous Neoplasms of the Pancreas in Liver Transplant Recipients

“…[1][2][3] In addition, posttransplant immunosuppression has been shown to accelerate carcinogenesis. 4 Serial abdominal crosssectional imaging (CSI) is regularly performed in pre-LT patients for operative planning and hepatocellular carcinoma screening, increasing the likelihood of incidental findings, including intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.…”

Good outcome after liver transplantation for ALD without a 6 months abstinence rule prior to transplantation including post-transplant CDT monitoring for alcohol relapse assessment - a retrospective study

“…In a previous study comprising 118 patients transplanted for ALD between 1982 and 1993 at the Medical University of Vienna, patients were found to be compliant regarding post‐LT clinical investigations and appointments for psychological counseling . Including any consumption of alcohol, 16.2% of our patients experienced an alcohol relapse during the observation period.…”

Survival after the diagnosis of de novo malignancy in liver transplant recipients

“…These results were further supported by a Spanish case–control study, though patients with and without cancer were not matched for gender and age . In addition, a recent investigation reported that patient survival was diminished only in the subset of patients with DNM excluding nonmelanoma skin cancer, compared with patients without cancer …”

“…Although DNM has been reported in some investigations as a major cause of late mortality after LT, few studies have evaluated the effects of cancer on survival comparing LT recipients who developed DNMs with corresponding LT recipients who did not . Moreover, none of these investigations has assessed cancer outcomes starting from the date of cancer diagnosis.…”