INTRODUCTION: The incidence of de novo malignancies after liver transplantation varies from 3-15%, and is greater than that in the general population. Immunosuppression may play a significant role in the development of most of these tumors. OBJECTIVE: To evaluate the incidence and clinical features of de novo tumors in liver transplant recipients in our center as well as to assess survival. PATIENTS AND METHODS: We retrospectively analyzed 437 liver transplantations (380 patients) performed from April 1990 to July 2001. The incidence of de novo malignancies was 7.4% (n = 28). Four patients presented two different tumors during their lifetime. The etiology of the underlying disease was alcoholic cirrhosis (45.8%), hepatitis C virus cirrhosis (20.8%), hepatitis B virus cirrhosis (12.5%), autoimmune disease (8.4%) and other causes (12.5%). The most frequent neoplasms were cutaneous and epidermoid tumors (21.4% of the malignancies both groups). All the patients with epidermoid tumors and adenocarcinomas were active smokers. The mean age at diagnosis was 58 9 years and this was a factor that influenced tumoral type (adenocarcinomas in older patients and epidermoid tumors in younger patients; p = 0.04). RESULTS: Sarcomas and adenocarcinomas appeared sooner after transplantation than epidermoid and cutaneous tumors (p = 0.04). Fifty percent of the malignancies developed in the second and third year after transplantation. The type of immunosuppression did not influence tumoral type, although most patients received cyclosporin A in combination with azathioprine and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 23.1 28 months (range, 1-81). Mortality was 58.4% with a median survival of 9 16 months. The actuarial probability of survival at 1, 3 and 5 years was 46.1, 27.7 and 27.7%, respectively. CONCLUSIONS: De novo malignancies are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow-up of these patients is essential for early diagnosis.
INTRODUCTION: The incidence of de novo malignancies after liver transplantation varies from 3-15%, and is greater than that in the general population. Immunosuppression may play a significant role in the development of most of these tumors. OBJECTIVE: To evaluate the incidence and clinical features of de novo tumors in liver transplant recipients in our center as well as to assess survival. PATIENTS AND METHODS: We retrospectively analyzed 437 liver transplantations (380 patients) performed from April 1990 to July 2001. The incidence of de novo malignancies was 7.4% (n = 28). Four patients presented two different tumors during their lifetime. The etiology of the underlying disease was alcoholic cirrhosis (45.8%), hepatitis C virus cirrhosis (20.8%), hepatitis B virus cirrhosis (12.5%), autoimmune disease (8.4%) and other causes (12.5%). The most frequent neoplasms were cutaneous and epidermoid tumors (21.4% of the malignancies both groups). All the patients with epidermoid tumors and adenocarcinomas were active smokers. The mean age at diagnosis was 58 9 years and this was a factor that influenced tumoral type (adenocarcinomas in older patients and epidermoid tumors in younger patients; p = 0.04). RESULTS:Sarcomas and adenocarcinomas appeared sooner after transplantation than epidermoid and cutaneous tumors (p = 0.04). Fifty percent of the malignancies developed in the second and third year after transplantation. The type of immunosuppression did not influence tumoral type, although most patients received cyclosporin A in combination with azathioprine and/or corticoids. The mean duration of follow-up after diagnosis of the tumor was 23.1 28 months (range, 1-81). Mortality was 58.4% with a median survival of 9 16 months. The actuarial probability of survival at 1, 3 and 5 years was 46.1, 27.7 and 27.7%, respectively. CONCLUSIONS: De novo malignancies are frequent after liver transplantation and their clinical course differs from that in the general population. Because their clinical course is more aggressive, regular follow-up of these patients is essential for early diagnosis.
Authors: Kymberly D S Watt; Rachel A Pedersen; Walter K Kremers; Julie K Heimbach; William Sanchez; Gregory J Gores Journal: Gastroenterology Date: 2009-09-18 Impact factor: 22.682
Authors: Bassem Hegab; Hatem Khalaf; Naglaa Allam; Ayman Azzam; Faisal Aba Al Khail; Waleed Al-hamoudi; Yasser Kamel; Hamad Al Bahili; Mohammed Al Sofayan; Mohammed Al-Sebayel Journal: Ann Saudi Med Date: 2012 Jul-Aug Impact factor: 1.526