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 multicenter, prospectively obtained database to assess the probabilities of and risk factors for de novo malignancies in patients after liver transplantation. METHODS: We analyzed the National Institute of Diabetes and Digestive and Kidney Diseases' liver transplantation database of 798 adults who received transplants from April 1990 to June 1994 and long-term follow-up data through January 2003. In this patient population, 171 adult patients developed 271 de novo malignancies. Of these malignancies, 147 were skin-related, 29 were hematologic, and 95 were solid organ cancers; we focused on nonskin malignancies. RESULTS: The probability of developing any nonskin malignancy was highest in patients with primary sclerosing cholangitis (PSC; 22% at 10 years) or alcohol-related liver disease (ALD; 18% at 10 years); all other diagnoses had a 10% probability. Multivariate analysis indicated that increased age by decade (hazard ratio [HR] = 1.33, P = .01), a history of smoking (HR = 1.6, P = .046), PSC (HR = 2.5, P = .001), and ALD (HR = 2.1, P = .01) were associated with development of solid malignancies after liver transplantation. The probabilities of death after diagnosis of hematologic and solid malignancy were 44.0% and 38.0% at 1 year and 57.6% and 53.1% at 5 years, respectively. CONCLUSIONS: De novo malignancy primarily affects patients with PSC or ALD, compared to other transplant recipients, with a significant impact on long-term survival.
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 multicenter, prospectively obtained database to assess the probabilities of and risk factors for de novo malignancies in patients after liver transplantation. METHODS: We analyzed the National Institute of Diabetes and Digestive and Kidney Diseases' liver transplantation database of 798 adults who received transplants from April 1990 to June 1994 and long-term follow-up data through January 2003. In this patient population, 171 adult patients developed 271 de novo malignancies. Of these malignancies, 147 were skin-related, 29 were hematologic, and 95 were solid organ cancers; we focused on nonskin malignancies. RESULTS: The probability of developing any nonskin malignancy was highest in patients with primary sclerosing cholangitis (PSC; 22% at 10 years) or alcohol-related liver disease (ALD; 18% at 10 years); all other diagnoses had a 10% probability. Multivariate analysis indicated that increased age by decade (hazard ratio [HR] = 1.33, P = .01), a history of smoking (HR = 1.6, P = .046), PSC (HR = 2.5, P = .001), and ALD (HR = 2.1, P = .01) were associated with development of solid malignancies after liver transplantation. The probabilities of death after diagnosis of hematologic and solid malignancy were 44.0% and 38.0% at 1 year and 57.6% and 53.1% at 5 years, respectively. CONCLUSIONS: De novo malignancy primarily affects patients with PSC or ALD, compared to other transplant recipients, with a significant impact on long-term survival.
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Authors: M V Catalina; A de Diego; A García-Sánchez; M Escudero; M Salcedo; R Bañares; G Clemente Journal: Gastroenterol Hepatol Date: 2003-02 Impact factor: 2.102
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Authors: J Ignacio Herrero; Juan Felipe Lucena; Jorge Quiroga; Bruno Sangro; Fernando Pardo; Fernando Rotellar; Javier Alvárez-Cienfuegos; Jesús Prieto Journal: Am J Transplant Date: 2003-11 Impact factor: 8.086
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Authors: Anne Marie Lennon; David Victor; Atif Zaheer; Mohammad Reza Ostovaneh; Jessica Jeh; Joanna K Law; Neda Rezaee; Marco Dal Molin; Young Joon Ahn; Wenchuan Wu; Mouen A Khashab; Mohit Girotra; Nita Ahuja; Martin A Makary; Matthew J Weiss; Kenzo Hirose; Michael Goggins; Ralph H Hruban; Andrew Cameron; Christopher L Wolfgang; Vikesh K Singh; Ahmet Gurakar Journal: Liver Transpl Date: 2014-12 Impact factor: 5.799
Authors: F Krenzien; M Quante; T Heinbokel; M Seyda; K Minami; H Uehara; H R C Biefer; J M Schuitenmaker; S Gabardi; K Splith; M Schmelzle; A K Petrides; H Azuma; J Pratschke; X C Li; A ElKhal; S G Tullius Journal: Am J Transplant Date: 2016-11-21 Impact factor: 8.086