1. De Novo Tumors Are a Major Cause of Late Mortality After Orthotopic Liver Transplantation
- Author
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Baccarani, U., Adani, G.L., Serraino, D., Lorenzin, D., Gambato, M., Buda, A., Zanus, G., Vitale, A., Piselli, P., De Paoli, A., Bresadola, V., Risaliti, A., Toniutto, P., Cillo, U., Bresadola, F., and Burra, P.
- Subjects
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LIVER transplantation , *TUMOR diagnosis , *REPORTING of diseases , *CANCER risk factors , *FOLLOW-up studies (Medicine) , *CANCER-related mortality , *CONFIDENCE intervals - Abstract
Abstract: The purpose of this study was to describe de novo post–orthotopic liver transplantation (OLT) malignancies for comparison with incidence rates in Italian cancer registries. Three hundred thirteen OLT patients engrafted from 1991 to 2006 and surviving 12 months without a previous diagnosis of cancer were evaluated for the development of de novo malignancies excluding nonmelanoma skin cancers. During a total follow-up time of 1753 PYs, 40 (12.8%) de novo malignancies were diagnosed in 40 recipients. The most common cancers were non-Hodgkin lymphoma (NHL; 20%), cancer of the head and neck (17%), Kaposi sarcoma (KS; 17%), and esophageal tumors (12%). The 1-, 3-, 5-, and 10-year estimated survival rates were 70%, 56%, 48%, and 39%. Patients with de novo cancers showed a lower 10-years survival rate (P = .0047) than patients without (39% vs 75%). The risk of cancer after OLT was 3-fold higher than that of the general population of the same age and gender (95% confidence interval [CI], 2.0–4.3). De novo tumor sites or types with significantly elevated standardized incidence ratios (SIRs) included KS (SIRs = 212), NHL (SIRs = 13.7), oesophagus (SIRs = 18.7), melanoma (SIRs = 10.1), and head and neck cancers (SIRs = 4.6). Tumors after OLT were associated with lower long-term survival, confirming that cancer is a major cause of late mortality. [Copyright &y& Elsevier]
- Published
- 2009
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