肝癌肝移植后第二原发癌：一项全国范围内基于人群的研究。
Second primary cancer after liver transplantation in hepatocellular carcinoma: a nationwide population-based study.
机构信息
Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea.
出版信息
Hepatol Int. 2017 Nov;11(6):523-528. doi: 10.1007/s12072-017-9824-z. Epub 2017 Oct 5.
PURPOSE
The aim of this study is to evaluate prevalence of second primary cancer (SPC) among hepatocellular carcinoma (HCC) patients after liver transplantation (LT) by using nationwide claims data from South Korea.
MATERIALS AND METHODS
The nationwide cohort included patients who were diagnosed with HCC and received LT from 1 January 2010 to 31 December 2014. We analyzed frequency and standardized incidence ratios (SIRs) to estimate the risk of SPC in HCC patients after LT.
RESULTS
A total of 2462 patients who were diagnosed with HCC and received LT were confirmed. Of these patients, 103 (4.2%) developed SPC after LT; the most common cancer site was lung (16.5%). Patients with HCC receiving LT had high risk of SPC [SIR 2.79, 95% confidence interval (CI) 2.27-3.38], particularly lymphoma (SIR 9.26), myeloma (SIR 10.60), and bladder cancer (SIR 7.19). The 12-, 24-, 36-, and 48-month overall survival for patients with HCC after LT was 92.7, 87.8, 84.6, and 82.1%, respectively.
CONCLUSIONS
HCC patients with LT had longer life expectancy and higher risk for SPC compared with the general population. Therefore, close surveillance for SPC is important in patients with HCC receiving LT.
目的
本研究旨在利用韩国全国性理赔数据评估肝癌（HCC）患者肝移植（LT）后第二原发癌（SPC）的发生率。
材料与方法
该全国性队列纳入了 2010 年 1 月 1 日至 2014 年 12 月 31 日期间被诊断为 HCC 并接受 LT 的患者。我们分析了频率和标准化发病比（SIR），以评估 HCC 患者 LT 后 SPC 的风险。
结果
共确认了 2462 例被诊断为 HCC 并接受 LT 的患者。其中 103 例（4.2%）在 LT 后发生了 SPC；最常见的癌症部位是肺部（16.5%）。接受 LT 的 HCC 患者发生 SPC 的风险较高[SIR 2.79，95%置信区间（CI）2.27-3.38]，特别是淋巴瘤（SIR 9.26）、骨髓瘤（SIR 10.60）和膀胱癌（SIR 7.19）。接受 LT 的 HCC 患者的 12、24、36 和 48 个月总生存率分别为 92.7%、87.8%、84.6%和 82.1%。
结论
与普通人群相比，接受 LT 的 HCC 患者的预期寿命更长，发生 SPC 的风险更高。因此，对接受 LT 的 HCC 患者进行 SPC 的密切监测很重要。
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