Malignancies following lung transplantation: the Portuguese experience

Abstract

Malignancy is an important complication after lung transplantation (LT), which is related to common risk factors in these patients, oncogenic viruses and immunosuppression therapy (IST). We retrospectively analyzed all cases of malignancy in the 182 patients that underwent LT between June 2001 and December 2017 in Portugal. We noticed an incidence of 7.6%, similar to that described in the literature, with a mean age of 53 years and a mean time after LT of 25 months. As in other series, the most common types of cancer were skin cancer (2.7%), post transplant lymphoproliferative disorders (2.2%) and lung cancer (1.6%). Unexpectedly we found an important incidence of gastric cancer (1,1%) not previously described in the literature that we relate to the elevated incidence of this cancer in our country. All patients underwent treatment and IST adjustments, according to a multidisciplinary team approach. In this series, 4 patients died due to cancer (33.3%) with a median survival of 26 months. We conclude that cancer is an important complication after LT and further investigation and awareness is needed to optimize diagnosis and management of this condition.