Renal transplant recipients suffer significantly more complications but not mortality after breast cancer surgery and benefit from treatment at transplant centers

Choubey, Ankur; Parsikia, Afshin; Dubchuk, Christina; Castaldi, Maria; Latifi, Rifat; Ortíz, Jorge

doi:10.21037/abs-20-56

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Breast cancer surgery outcomes data following solid organ transplantation has largely focused onthose with kidney transplantation [20]. Consequently, little attention has been afforded to LTR subsequentlytreated for BC.…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation Does Not Increase Morbidity or Mortality in Women Undergoing Surgery for Breast Cancer

Roberts

Veillette

Castaldi

et al. 2023

Journal of the American College of Surgeons

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The incidence of breast cancer (BC) in solid organ transplant recipients is comparable to the agematched general population. The rate of reported de novo breast cancer following liver transplantation (LT) varies. Further, there is limited information on the management and outcomes of breast cancer in liver transplant recipients (LTR). We aim to evaluate the impact of LT on breast cancer surgery outcomes.Further we compare the outcomes after breast cancer surgery in LTR in transplant versus non-transplant centers. MethodsNational Inpatient Sample (NIS) database was accessed to identify LTR with BC. Mortality, complications, hospital charges and total length of stay (LOS) were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. ResultsNinety-nine women met inclusion criteria for LT + BC and were compared against a cohort of women with BC without LT (n=736,527). LT + BC had lower performance status as con rmed via higher Elixhauser Comorbidity Index (20.5% vs.10.2%, p < 0001). There were signi cantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p=0.012). However, on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery (OR 1.223, p=0.480). Cost associated with breast cancer care was signi cantly higher in those with LT (2.621, p<0.001). Breast conservation surgery in LT had shorter LOS as compared to BC alone (OR 0.568, p 0.027) in all hospitals. ConclusionLT does not increase short-term mortality when undergoing breast cancer surgery. Although there were signi cantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p=0.012), on multivariate analysis, LT was not an independent risk factor for postoperative complications following breast cancer surgery. Additionally, breast cancer treatment is more costly in LTR. Breast cancer management in LTR at non-transplant centers incurred higher charges but no difference in complication rate, nor LOS when compared to breast cancer management in LTR at transplant centers.

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Section: Introductionmentioning

confidence: 99%

Liver Transplantation Does Not Increase Morbidity or Mortality in Women Undergoing Surgery for Breast Cancer

Roberts

Veillette

Castaldi

et al. 2023

Journal of the American College of Surgeons

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show abstract

“…Breast cancer surgery outcomes data following solid organ transplantation has largely focused on those with kidney transplantation. 20 Consequently, little attention has been afforded to LTR subsequently treated for BC. Since LT has become a common procedure and recipients live with allografts, it is imperative to develop a greater understanding of the outcomes of breast cancer surgery in this cohort.…”

Section: Introductionmentioning

confidence: 99%

“…However, this cohort consisted of only 17 women, 2 of whom underwent an LT. 17 Similarly, in a case report by Nakakimura et al, 18 no severe adverse events were observed in one woman who underwent breast surgery and chemotherapy following an LT. Others observed higher mortality when diagnosed with higher stage breast cancer after LT. 19 Breast cancer surgery outcomes data following solid organ transplantation has largely focused on those with kidney transplantation. 20 Consequently, little attention has been afforded to LTR subsequently treated for BC. Since LT has become a common procedure and recipients live with allografts, it is imperative to develop a greater understanding of the outcomes of breast cancer surgery in this cohort.…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation does not increase morbidity or mortality in women undergoing surgery for breast cancer

Veillette

Castaldi

Roberts

et al. 2022

Womens Health (Lond Engl)

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Purpose: The incidence of breast cancer following solid organ transplantation is comparable to the age-matched general population. The rate of de novo breast cancer following liver transplantation varies. Furthermore, there is limited information on the management and outcomes of breast cancer in liver transplant recipients. We aim to evaluate the impact of liver transplantation on breast cancer surgery outcomes and compare the outcomes after breast cancer surgery in liver transplant recipient in transplant versus non-transplant centers. Methods: National Inpatient Sample database was accessed to identify liver transplant recipient with breast cancer. Mortality, complications, hospital charges, and total length of stay were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results: Ninety-nine women met inclusion criteria for liver transplantation + breast cancer and were compared against women with breast cancer without liver transplantation (n = 736,527). Liver transplantation + breast cancer had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs 10.2%, p < 0001). There were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012). However, on multivariate analysis, liver transplantation was not an independent risk factor for post-operative complications following breast cancer surgery (odd ratio, 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with liver transplantation (2.621, p < 0.001). Breast conservation surgery in liver transplantation had shorter length of stay as compared to breast cancer alone (odds ratio, 0.568, p = 0.027) in all hospitals. Conclusion: Liver transplantation does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012), on multivariate analysis, liver transplantation was not an independent risk factor for postoperative complications following breast cancer surgery. Breast cancer management in liver transplant recipient at non-transplant centers incurred higher charges but no difference in complication rate or length of stay when compared to transplant centers.

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“…Breast cancer surgery outcomes data following solid organ transplantation has largely focused on those with kidney transplantation 20 . Consequently, little attention has been afforded to LTR subsequently treated for BC.…”

Section: Introductionmentioning

confidence: 99%

Liver Transplant Recipients Incur More Costly Care When Undergoing Treatment for Breast Cancer

Veillette¹,

Castaldi²,

Roberts³

et al. 2021

Preprint

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Purpose The incidence of breast cancer (BC) in solid organ transplant recipients is comparable to the age-matched general population. It is among the three top-most commonly occurring cancers in women after liver transplantation (LT). There is limited information on the management and outcomes of breast cancer in liver transplant recipients (LTR). We aim to evaluate the impact of LT on breast cancer surgery outcomes. Further we compare the outcomes after breast cancer surgery in LTR in transplant versus non-transplant centers. Methods National Inpatient Sample (NIS) database was accessed to identify LTR with BC. Mortality, complications, hospital charges and total length of stay (LOS) were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results Ninety-nine women met inclusion criteria for LT + BC and were compared against a cohort of women with BC without LT (n = 736,527). LT + BC had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs.10.2%, p < 0001). There were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p = 0.012). However, on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery (OR 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with LT (2.621, p < 0.001). Breast conservation surgery in LT had shorter LOS as compared to BC alone (OR 0.568, p 0.027) in all hospitals. Conclusion LT does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the LT cohort when compared to the non-LTR (15.0% vs. 8.2%, p = 0.012), on multivariate analysis, LT was not an independent risk factor for post-operative complications following breast cancer surgery. Additionally, breast cancer treatment is more costly in LTR.

show abstract

Renal transplant recipients suffer significantly more complications but not mortality after breast cancer surgery and benefit from treatment at transplant centers

Cited by 5 publications

References 20 publications

Liver Transplantation Does Not Increase Morbidity or Mortality in Women Undergoing Surgery for Breast Cancer

Liver Transplantation Does Not Increase Morbidity or Mortality in Women Undergoing Surgery for Breast Cancer

Liver transplantation does not increase morbidity or mortality in women undergoing surgery for breast cancer

Liver Transplant Recipients Incur More Costly Care When Undergoing Treatment for Breast Cancer

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