Clinical Research Article
De novo malignancies after liver transplantation: clinical characteristics and management strategies
Rao Wei, Zhai Huimin, Song Mingquan, Yu Ting, Sun Xueguo, Li Qian, Guo Yuan, Wu Liqun, Cai Jinzhen, Xie Man
Published 2022-10-28
Cite as Chin J Hepatobiliary Surg, 2022, 28(10): 726-730. DOI: 10.3760/cma.j.cn113884-20220420-00178
Abstract
ObjectiveTo investigate the clinical characteristics of de novo malignancies (DNMs) after liver transplantation (LT) and to study the clinical management strategies.
MethodsAdult LT recipients who were regularly followed-up in the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2005 to April 2021 were enrolled in this study. The clinical characteristics of DNMs were retrospectively analyzed. Of 601 LT recipients, there were 105 females and 496 males, aged (51.4±9.6) years old. They were divided into the DNMs group (n=26) and the non-DNMs group (n=575) according to whether there were DNMs on followed-up. Clinical data including age, sex, basic diseases before LT and operation time were collected. These patients were follow-up in outpatient clinics.
ResultsTwenty-six patients were diagnosed to develop DNMs after LT, but there were 28 DNMs (of which 2 patients were diagnosed to have DNMs twice). The incidence of DNMs after LT was 4.3% (26/601), the median time from LT to DNMs was 42 (20, 70) months, and the cumulative incidence rates of DNMs were 0.5%, 2.0%, 6.3%, 21.0% and 34.5% at 1, 3, 5, 10 and 15 years after LT, respectively. Among the 28 DNMs, digestive system tumors were most common, with 17 lesions (60.7%), followed by 3 lesions (11.1%) of lung cancer, 2 lesions (7.4%) of lymphoproliferative diseases, and 1 lesion (3.7%) of cervical cancer, thyroid cancer, soft palate cancer, eyelid cancer, laryngeal cancer, and prostate cancer. The follow-up time of 55.9 (36.6, 102.5) months in the DNMs group after LT was longer than the 33.4 (18.5, 58.9) months in the non-DNMs group (P<0.001). The 1, 5, and 10 year survival rates of patients with DNMs after LT were 96.3%, 83.5%, and 49.8%, respectively. The 1, 5, and 10 year survival rates of patients with non-DNMs after LT were 94.5%, 77.7%, and 75.4%, respectively. There was no significant difference in the cumulative survival rates between the two groups (log rank=0.402, P=0.526).
ConclusionThe incidence of DNMs in LT recipients was 4.3%. The majority of them were digestive system tumors. Early diagnosis and treatment of DNMs significantly improved the prognosis and quality of life of these patients.
Key words:
Liver transplantation; Neoplasms; Stomach neoplasms; Colorectal neoplasms
Contributor Information
Rao Wei
Liver Disease Center, Organ Transplantation Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Zhai Huimin
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Song Mingquan
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Yu Ting
Department of Hospital Infection Control, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Sun Xueguo
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Li Qian
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Guo Yuan
Liver Disease Center, Organ Transplantation Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Wu Liqun
Liver Disease Center, Organ Transplantation Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Cai Jinzhen
Liver Disease Center, Organ Transplantation Center, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
Xie Man
Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
