Klikovits Thomas, Lambers Christopher, Ghanim Bahil, Dome Balazs, Murakoezy Gabriella, Zöchbauer-Müller Sabine, Waseda Ryuichi, Aigner Clemens, Lang Gyoergy, Taghavi Shahrokh, Klepetko Walter, Jaksch Peter, Hoda Mir Alireza
Division of Thoracic Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Clin Transplant. 2016 Aug;30(8):912-7. doi: 10.1111/ctr.12764. Epub 2016 Jun 16.
Incidentally discovered lung cancers in lung transplant (LuTX) recipients are rare but may affect outcome. We aim to report our single center experience with incidence, management, and survival of patients with previously unverified primary lung cancer discovered at the time of LuTX.
A total of 1262 patients undergoing LuTX between 1989 and 2012 were retrospectively analyzed in our prospective database.
Patients identified were six men and five women with a mean age of 54.4±9.9 years. The indication for LuTX was COPD (n=9), pulmonary fibrosis (n=1), and cystic fibrosis (n=1). Histological diagnosis of the explanted lung revealed adenocarcinoma in six, squamous cell carcinoma in three, and lepidic predominant adenocarcinoma in two cases, respectively. Staging revealed stage IA (pT1a/b pN0) in eight and IB (pT2a pN0) in two cases and one patient in stage IIA (pT1b pN1). Subsequent cancer staging after LuTX revealed no metastasis. Immunosuppression was adjusted and no adjuvant chemo- or radiotherapy was administered. The 5-year survival rate was 90.5% with no detection of recurrence.
In patients with incidentally detected early stage lung cancer at the time of LuTX, rates of recurrence and survival based on this sample appear to be acceptable.
在肺移植（LuTX）受者中偶然发现的肺癌很罕见，但可能影响预后。我们旨在报告我们单中心关于LuTX时发现的既往未确诊原发性肺癌患者的发病率、治疗及生存情况的经验。
对1989年至2012年间在我们前瞻性数据库中接受LuTX的1262例患者进行回顾性分析。
确诊患者为6名男性和5名女性，平均年龄54.4±9.9岁。LuTX的指征为慢性阻塞性肺疾病（COPD，n = 9）、肺纤维化（n = 1）和囊性纤维化（n = 1）。切除肺的组织学诊断分别显示6例为腺癌、3例为鳞状细胞癌、2例为鳞屑为主型腺癌。分期显示8例为IA期（pT1a/b pN0），2例为IB期（pT2a pN0），1例为IIA期（pT1b pN1）。LuTX后的后续癌症分期显示无转移。调整了免疫抑制，未给予辅助化疗或放疗。5年生存率为90.5%，未检测到复发。
对于LuTX时偶然发现早期肺癌的患者，基于该样本的复发率和生存率似乎是可以接受的。
