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De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival.

Abstract

Immunosuppression increases the risk of posttransplant malignancy and it may increase posttransplant mortality. The finding of factors related to the development of posttransplant malignancy may serve as a guide to avoid those risk factors and to develop strategies of posttransplant surveillance. The incidence and risk factors of malignancy were studied in 187 consecutive liver transplant recipients surviving more than 3 months. None of the 12 patients surviving less than 3 months had de novo neoplasia. The impact of malignancy on survival was studied in a case-control study. After a median follow-up of 65 months, 49 patients developed 63 malignancies: 25 patients had 35 cutaneous neoplasias and 27 patients had 28 noncutaneous malignancies. The 5- and 10-year actuarial rates of cutaneous neoplasia were 14 and 24% and the rates of noncutaneous neoplasia were 11 and 22%, respectively. Risk factors for the development of cutaneous malignancy were older age and Child-Turcotte-Pugh A status. Risk factors for the development of noncutaneous malignancy were older age, alcoholism, and smoking. Cutaneous neoplasia had no effect on survival, whereas patients with noncutaneous malignancy had a significant reduction of survival. The overall relative risk of cutaneous and noncutaneous neoplasia, as compared with the general population were 16.91 (95% confidence interval: 11.78-23.51) and 3.23 (95% confidence interval: 2.15-4.67), respectively. The relative risk of cancer-related mortality (after excluding recurrent malignancy) was 2.93 (95% confidence interval: 1.56-5.02). Multivariate analysis showed that noncutaneous malignancy was an independent risk factor for posttransplant mortality. In conclusion, liver transplant recipients have a higher risk of cancer-related mortality than the general population. This increased risk is due to the development of noncutaneous neoplasia. Older age, alcoholism, and smoking increase the risk of de novo noncutaneous neoplasia.

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  • Authors+Show Affiliations

    ,

    Liver Unit, Clí nica Universitaria, Av. Pio XII, 36 31008 Pamplona, Spain. iherrero@unav.es

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    Source

    MeSH

    Aged
    Female
    Humans
    Liver Transplantation
    Lymphoma, B-Cell
    Male
    Middle Aged
    Neoplasms
    Postoperative Complications
    Prevalence
    Retrospective Studies
    Risk Factors
    Survival Rate

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15690541

    Citation

    Herrero, J Ignacio, et al. "De Novo Neoplasia After Liver Transplantation: an Analysis of Risk Factors and Influence On Survival." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 11, no. 1, 2005, pp. 89-97.
    Herrero JI, Lorenzo M, Quiroga J, et al. De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival. Liver Transpl. 2005;11(1):89-97.
    Herrero, J. I., Lorenzo, M., Quiroga, J., Sangro, B., Pardo, F., Rotellar, F., ... Prieto, J. (2005). De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 11(1), pp. 89-97.
    Herrero JI, et al. De Novo Neoplasia After Liver Transplantation: an Analysis of Risk Factors and Influence On Survival. Liver Transpl. 2005;11(1):89-97. PubMed PMID: 15690541.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival. AU - Herrero,J Ignacio, AU - Lorenzo,María, AU - Quiroga,Jorge, AU - Sangro,Bruno, AU - Pardo,Fernando, AU - Rotellar,Fernando, AU - Alvarez-Cienfuegos,Javier, AU - Prieto,Jesús, PY - 2005/2/4/pubmed PY - 2005/4/29/medline PY - 2005/2/4/entrez SP - 89 EP - 97 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 11 IS - 1 N2 - Immunosuppression increases the risk of posttransplant malignancy and it may increase posttransplant mortality. The finding of factors related to the development of posttransplant malignancy may serve as a guide to avoid those risk factors and to develop strategies of posttransplant surveillance. The incidence and risk factors of malignancy were studied in 187 consecutive liver transplant recipients surviving more than 3 months. None of the 12 patients surviving less than 3 months had de novo neoplasia. The impact of malignancy on survival was studied in a case-control study. After a median follow-up of 65 months, 49 patients developed 63 malignancies: 25 patients had 35 cutaneous neoplasias and 27 patients had 28 noncutaneous malignancies. The 5- and 10-year actuarial rates of cutaneous neoplasia were 14 and 24% and the rates of noncutaneous neoplasia were 11 and 22%, respectively. Risk factors for the development of cutaneous malignancy were older age and Child-Turcotte-Pugh A status. Risk factors for the development of noncutaneous malignancy were older age, alcoholism, and smoking. Cutaneous neoplasia had no effect on survival, whereas patients with noncutaneous malignancy had a significant reduction of survival. The overall relative risk of cutaneous and noncutaneous neoplasia, as compared with the general population were 16.91 (95% confidence interval: 11.78-23.51) and 3.23 (95% confidence interval: 2.15-4.67), respectively. The relative risk of cancer-related mortality (after excluding recurrent malignancy) was 2.93 (95% confidence interval: 1.56-5.02). Multivariate analysis showed that noncutaneous malignancy was an independent risk factor for posttransplant mortality. In conclusion, liver transplant recipients have a higher risk of cancer-related mortality than the general population. This increased risk is due to the development of noncutaneous neoplasia. Older age, alcoholism, and smoking increase the risk of de novo noncutaneous neoplasia. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/15690541/De_Novo_neoplasia_after_liver_transplantation:_an_analysis_of_risk_factors_and_influence_on_survival_ L2 - https://doi.org/10.1002/lt.20319 DB - PRIME DP - Unbound Medicine ER -