Extensive Surveillance Promotes Early Diagnosis and Improved Survival of De Novo Malignancies in Liver Transplant Recipients

被引:116
作者
Finkenstedt, Armin [1 ]
Graziadei, Ivo W. [1 ]
Oberaigner, Wilhelm [2 ]
Hilbe, Wolfgang [3 ]
Nachbaur, Karin [1 ]
Mark, Walter [4 ]
Margreiter, Raimund [4 ]
Vogel, Wolfgang [1 ]
机构
[1] Innsbruck Med Univ, Dept Internal Med Gastroenterol & Hepatol 2, Innsbruck, Austria
[2] Innsbruck Med Univ, Canc Registry Tyrol, Dept Clin Epidemiol, Tyrolean State Hosp Ltd, Innsbruck, Austria
[3] Innsbruck Med Univ, Dept Internal Med Hematol & Oncol 5, Innsbruck, Austria
[4] Innsbruck Med Univ, Dept Transplantat Surg, Innsbruck, Austria
关键词
Cancer; complications; liver transplantation; SCLEROSING CHOLANGITIS; RISK-FACTORS; LUNG-CANCER; NEOPLASIA; DISEASE; COLON;
D O I
10.1111/j.1600-6143.2009.02766.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
The aim of our study was to examine whether an extensive surveillance protocol will promote early diagnosis and improved survival in patients with de novo cancer following liver transplantation (LT). Of 779 consecutive LT recipients, 96 (12.3%) developed 105 malignancies. The cumulative risk for the development of de novo cancer was 10%, 24%, 32% and 42% at 5, 10, 15 and 20 years after LT, respectively. The most frequent tumor types were skin (17%), lung (16%), oropharyngeal (11%) and prostate cancer (11%). The overall standard incidence ratio as compared to that of the general population was 1.9 (95% CI: 1.5-2.3). The median survival of patients with de novo non-skin cancers was 3.1 years after diagnosis. Only patients with skin cancers and solid tumors, diagnosed at early stages, showed an excellent outcome. After introducing an intensified surveillance protocol, the detection rate of de novo cancers increased from 4.9% to 13% and more de novo malignancies were diagnosed in earlier stages. For non-skin cancers, the median tumor-related survival significantly improved from 1.2 to 3.3 years as well as the median overall survival post-LT. This study indicates that an extensive tumor surveillance program is highly recommendable in LT recipients.
引用
收藏
页码:2355 / 2361
页数:7
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