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肝移植术后新发恶性肿瘤:与韩国癌症登记处的发病率比较。

De novo malignancies after liver transplantation: incidence comparison with the Korean cancer registry.

作者信息

Park H W, Hwang S, Ahn C S, Kim K H, Moon D B, Ha T Y, Song G W, Jung D H, Park G C, Namgoong J M, Yoon S Y, Park C S, Park Y H, Lee H J, Lee S G

机构信息

Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Transplant Proc. 2012 Apr;44(3):802-5. doi: 10.1016/j.transproceed.2012.01.027.

Abstract

PURPOSE

De novo malignancy is not uncommon after liver transplantation (OLT). We have compared the incidence of novo malignancy following OLT with those among the general Korean population.

METHODS

Between January 1998 and December 2008, 1952 adult OLT were performed, including 1714 living donor and 238 deceased donor grafts whose medical records were retrospectively reviewed.

RESULTS

Among the 1952 patients, 44 (2.3%) showed de novo malignancies after a mean posttransplant period of 41 months. Among the 14 types of malignancy the most frequent was stomach cancer (n = 11; 25.0%), colorectal cancer (n = 9; 20.5%), breast cancer (n = 4; 9.1%), and thyroid cancer (n = 3; 6.8%). These patients underwent aggressive treatment, including surgery, chemotherapy, and radiotherapy, except for one patient with an aggressive primary liver cancer. Over a mean follow-up of 45 months after diagnosis of de novo malignancy, 13 patients (29.5%) died; the overall 3-year patient survival rate was 67.5%. The relative risk of malignancy following OLT was 7.7-fold higher in men and 7.3-fold higher in women than the Korean general population.

CONCLUSIONS

OLT recipients must be checked periodically for de novo malignancy throughout their lives, especially for cancers common in the general population.

摘要

目的

肝移植(OLT)后新发恶性肿瘤并不少见。我们比较了OLT后新发恶性肿瘤的发生率与韩国普通人群的发生率。

方法

1998年1月至2008年12月期间,共进行了1952例成人OLT,其中包括1714例活体供肝移植和238例尸体供肝移植,对其病历进行了回顾性分析。

结果

在1952例患者中,44例(2.3%)在移植后平均41个月出现新发恶性肿瘤。在14种恶性肿瘤类型中,最常见的是胃癌(n = 11;25.0%)、结直肠癌(n = 9;20.5%)、乳腺癌(n = 4;9.1%)和甲状腺癌(n = 3;6.8%)。除1例原发性肝癌进展迅速的患者外,这些患者均接受了积极治疗,包括手术、化疗和放疗。在新发恶性肿瘤诊断后的平均45个月随访期内,13例患者(29.5%)死亡;总体3年患者生存率为67.5%。OLT后发生恶性肿瘤的相对风险在男性中比韩国普通人群高7.7倍,在女性中高7.3倍。

结论

OLT受者必须终生定期检查新发恶性肿瘤,尤其是普通人群中常见的癌症。

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