Crespo-Leiro M G, Alonso-Pulpón L A, Villa-Arranz A, Brossa-Loidi V, Almenar-Bonet L, González-Vilchez F, Delgado-Jiménez J F, Manito-Lorite N, Díaz-Molina B, Rábago G, Arizón-del Prado J M, Romero-Rodríguez N, Brossa V, Blasco-Peiró T, Pascual-Figal D, de la Fuente-Galán L, Muñiz-García J
Servicio de Cardiología, H. A Coruña, Hospital Universitario A Coruña, La Coruña, Spain.
Transplant Proc. 2010 Oct;42(8):3011-3. doi: 10.1016/j.transproceed.2010.08.010.
Malignancy is a major complication in the management of solid organ transplant patients. Skin cancers show a better prognosis than other neoplasms, but not all others are equal: Ideally, patient management must take into account the natural history of each type of cancer in relation to the transplanted organs. We sought to determine the prognosis of various groups of noncutaneous nonlymphomatous (NCNL) cancers after heart transplantation (HT).
We retrospectively analyzed the records of the Spanish Post-Heart-Transplant Tumour Registry, which collects data on posttransplant tumors in all patients who have undergone HT in Spain since 1984. Data were included in the study up to December 2008. We considered only the first NCNL post-HT tumors.
Of 4359 patients, 375 developed an NCNL cancer. The most frequent were cancers of the lung (n=97; 25.9%); gastrointestinal tract (n=52; 13.9%); prostate gland (n=47; 12.5%; 14.0% of men), bladder (n=32; 8.5%), liver (n=14; 3.7%), and pharynx (n=14; 3.7%), as well as Kaposi's sarcoma (n=11; 2.9%). The corresponding Kaplan-Meier survival curves differed significantly (P<.0001; log-rank test), with respective survival rates of 47%, 72%, 91%, 73%, 36%, 64%, and 73% at 1 year versus 26%, 62%, 89%, 56%, 21%, 64%, and 73% at 2 years; and 15%, 51%, 77%, 42%, 21%, 64%, and 52% at 5 years post-diagnosis, respectively.
Mortality among HT patients with post-HT NCNL solid organ cancers was highest for cancers of the liver or lung (79%-85% at 5 years), and lowest for prostate cancer (23%).
恶性肿瘤是实体器官移植患者管理中的主要并发症。皮肤癌的预后优于其他肿瘤，但并非所有其他肿瘤都相同：理想情况下，患者管理必须考虑每种癌症相对于移植器官的自然病程。我们试图确定心脏移植（HT）后各类非皮肤非淋巴瘤（NCNL）癌症的预后。
我们回顾性分析了西班牙心脏移植后肿瘤登记处的记录，该登记处收集了自1984年以来在西班牙接受HT的所有患者的移植后肿瘤数据。数据纳入研究截至2008年12月。我们仅考虑HT后首个NCNL肿瘤。
在4359例患者中，375例发生了NCNL癌症。最常见的是肺癌（n = 97；25.9%）；胃肠道癌（n = 52；13.9%）；前列腺癌（n = 47；12.5%；男性的14.0%），膀胱癌（n = 32；8.5%），肝癌（n = 14；3.7%），咽癌（n = 14；3.7%），以及卡波西肉瘤（n = 11；2.9%）。相应的Kaplan-Meier生存曲线差异显著（P <.0001；对数秩检验），1年时的生存率分别为47%、72%、91%、73%、36%、64%和73%，2年时为26%、62%、89%、56%、21%、64%和73%；诊断后5年时分别为15%、51%、77%、42%、21%、64%和52%。
HT后患有NCNL实体器官癌症的HT患者中，肝癌或肺癌的死亡率最高（5年时为79% - 85%），前列腺癌的死亡率最低（23%）。
