Merchea Amit, Abdelsattar Zaid M, Taner Timucin, Dean Patrick G, Colibaseanu Dorin T, Larson David W, Dozois Eric J
Section of Colon and Rectal Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32256, USA,
J Gastrointest Surg. 2014 Mar;18(3):599-604. doi: 10.1007/s11605-013-2402-3. Epub 2013 Nov 20.
The incidence of colorectal cancer posttransplantation is unclear. Limited reports exist and have conflicting conclusions. We aimed to review the clinical features and oncologic outcomes of colorectal cancer in transplant recipients at our institution.
A retrospective review of all patients diagnosed with colorectal cancer after solid organ transplantation between 2000 and 2011 was conducted. Clinical features and outcomes were reviewed.
Twenty of 3,946 patients were identified. The most common single organ transplanted was the kidney (n = 8). Six patients had multiorgan transplantation. Median age of diagnosis of cancer was 64.3 years, and median time from transplant to diagnosis of cancer was 8.7 years. Ten patients were symptomatic at presentation. Cancer was identified on routine colonoscopy in seven patients. Tumors were most commonly found in the right colon (n = 14, 70%). Six patients had stage IV disease at presentation. Short-term morbidity was identified in 11 patients. Postoperative mortality occurred in one patient. Median follow-up was 2.47 years. Overall survival at 5 years was 69%, and disease-free survival was 68 %. Distant recurrence was seen in 3 (15%) patients.
Colorectal cancer in these patients is rare, and surgery can be done safely. Vigilant screening must be maintained in this patient population.
移植后结直肠癌的发病率尚不清楚。现有报道有限且结论相互矛盾。我们旨在回顾我院移植受者结直肠癌的临床特征和肿瘤学结局。
对2000年至2011年间所有诊断为实体器官移植后结直肠癌的患者进行回顾性研究。回顾临床特征和结局。
在3946例患者中识别出20例。最常见的单一移植器官是肾脏（n = 8）。6例患者进行了多器官移植。癌症诊断的中位年龄为64.3岁，从移植到癌症诊断的中位时间为8.7年。10例患者就诊时出现症状。7例患者在常规结肠镜检查时发现癌症。肿瘤最常见于右半结肠（n = 14，70%）。6例患者就诊时为IV期疾病。11例患者出现短期并发症。1例患者术后死亡。中位随访时间为2.47年。5年总生存率为69%，无病生存率为68%。3例（15%）患者出现远处复发。
这些患者中的结直肠癌罕见，手术可安全进行。必须对该患者群体保持警惕性筛查。
