Risk factors of lung, head and neck, esophageal, and kidney and urinary tract carcinomas after liver transplantation: The effect of smoking withdrawal

Abstract

Liver transplant recipients have an increased risk of malignancy. Smoking is related to some of the most frequent causes of posttransplant malignancy. The incidence and risk factors for the development of neoplasia related to smoking (head and neck, lung, esophageal, and kidney and urinary tract carcinomas) were studied in 339 liver transplant recipients. Risk factors for the development of smoking-related neoplasia were also studied in 135 patients who had a history of smoking so that it could be determined whether smoking withdrawal was associated with a lower risk of malignancy. After a mean follow-up of 7.5 years, 26 patients were diagnosed with 29 smoking-related malignancies. The 5-and 10-year actuarial rates were 5% and 13%, respectively. In multivariate analysis, smoking and older age were independently associated with a higher risk of malignancy. In the smoker subgroup, the variables related to a higher risk of malignancy were active smoking and older age. In conclusion, smoking withdrawal after liver transplantation may have a protective effect against the development of neoplasia. Liver Transpl 17:402-408,

Postoperative Pulmonary Complications in Living-Liver Donors: A Retrospective Analysis of 188 Patients

“…12 Some studies have shown beneficial effects of smoking cessation on liver and kidney recipients. 13,14 However, there are insufficient data about smoking-related morbidity and mortality in liver donors.…”

Liver Transplantation for Alcohol-Related Liver Disease

“…Active smoking after transplantation in ALD has been shown to be an independent predictor of long-term morbidity and mortality, either from cardiovascular complications or from de novo neoplasms. 61 Herrero et al 62 showed that withdrawal smoking was associated with lower risk of de novo malignancies after liver transplantation. Also, smoking is a major risk for cardiovascular disease, and thus contributes to late mortality after transplantation, independent of malignancy development.…”

Noncutaneous head and neck cancer in solid organ transplant patients: Single center experience

“…Tumors in the head and neck area cover about 3.5-15% of all malignancies after transplantation [3][4][5]. A large part of these head and neck cancers (HNC) are squamous cell carcinomas (SCC) of the lip or oropharynx [6][7][8][9][10][11][12]. The exact mechanism for carcinogenesis under immunosuppression remains unclear, however it is clearly a multifactorial process [2].…”

“…The impact of tobacco exposure and the synergistic carcinogenic effect of alcohol have long been demonstrated in the general population. In transplant patients, tobacco and/or alcohol also increase the risk of developing HNC (HR = 9.2; 95% CI 2.0-42.0; p = 0.004) [4,6,8,12].…”

“…In general, the cancer progresses at a faster rate in transplant recipients and is more refractory to treatment, which explains the worse prognosis [4,15]. In addition, most often, patients are diagnosed at an advanced stage of HNC (stage III or IV), limiting the therapeutic options [4,6,12].…”