Long-term Probability of and Mortality From De Novo Malignancy After Liver Transplantation

Abstract

Background & Aims-Information about malignancies that arise in patients after liver transplantation comes from volunteer registry databases and single-center retrospective studies. We analyzed a multi-center, prospectively obtained database to assess the probabilities of and risk factors for de novo malignancies in patients after liver transplantation.

Case Report: Bone Tumor of the Scapula in a Patient Undergoing Liver Transplantation

“…Although the occurrence of a bone tumor after liver transplantation was reported in one series [17], we describe the case of a patient with such a tumor in detail. Our finding also suggests the possibility of an aggressive fibrous histiocytoma after liver transplantation with chronic immunosuppression.…”

“…Sixty-seven patients had at least one noncutaneous malignancy for an overall incidence of 12.7%, 18% had posttransplant lymphoproliferative disease, 14% had lung cancer, 4% had Kaposi's sarcoma, 7% had genitourinary malignancies, and 17% had oropharyngeal or laryngeal cancer. Watt et al [17] also analyzed 798 adults in a multiple-center study (Mayo Clinic, University of Nebraska, and University of California at San Francisco), who received transplants; 171 adult patients had 271 de novo malignancies develop; 147 were skin-related, 29 were hematologic, and 95 were solid organ cancers. Only one malignancy was found in bone and there was no further description of that patient.…”

“…Bone involvement is rare and difficult to diagnose. We found only one report of documented bone sarcoma after liver transplantation [17], although there were no additional data or analysis of this patient. We report the case of a patient with a low-grade, aggressive fibrous histiocytoma of the scapula that had been treated 6 years earlier by liver transplantation.…”

Long-term Medical Management of the Liver Transplant Recipient: What the Primary Care Physician Needs to Know

“…[52][53][54] In a large, multicenter, long-term database study of 798 adult LT recipients, the probability of developing any de novo malignancy within 1, 5, and 10 years was 3.5%, 11.9%, and 21.7%, respectively. 52 One reason for this increased incidence is that the long-term use of immunosuppressive medications (particularly azathioprine and MMF) is thought to impair cancer surveillance mechanisms and create an environment for oncogenic viruses to thrive. In addition to immunosuppressant use, age, alcohol use before transplant, current or former cigarette smoking, and primary sclerosing cholangitis (PSC) are risk factors for de novo malignancy after OLT.…”

“…In addition to immunosuppressant use, age, alcohol use before transplant, current or former cigarette smoking, and primary sclerosing cholangitis (PSC) are risk factors for de novo malignancy after OLT. 52,53,55 Skin cancers are the most common de novo malignancies after OLT, accounting for almost half of all cancers, with an equal distribution between basal cell and squamous cell cancer, although the incidence of the latter is about 100 times more than that in the general population. 56,57 The 5-and 10-year probability of skin cancer is estimated at 5.9% and 10.8%, respectively.…”