Egeli Tufan, Unek Tarkan, Ozbilgin Mucahit, Agalar Cihan, Derici Serhan, Akarsu Mesut, Unek Ilkay Tugba, Aysin Murat, Bacakoglu Aylin, Astarcıoglu Ibrahim
From the Department of General Surgery, Liver Transplantation and Hepatopancreaticobiliary Surgery Unit, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Exp Clin Transplant. 2019 Feb;17(1):74-78. doi: 10.6002/ect.2017.0111. Epub 2017 Dec 14.
Our objective was to analyze characteristics, risk factors, and incidence of de novo malignancies after liver transplant.
The hospital records of 557 patients who underwent liver transplant were analyzed from the point of de novo malignancy development. We evaluated the demographic features and survival of these patients retrospectively.
The research covered 429 patients, 9 (2%) of whom developed de novo malignancy. All of these patients were male (100%), and their mean (SD) age was 51.33 (4.69) years (range, 45-65 y). Indications for transplant included alcohol related in 4 cases, chronic hepatitis B in 2 cases, chronic hepatitis B and C in 1 case, chronic hepatitis B and D in 1 case, and chronic hepatitis C and alcohol-related cirrhosis in 1 case. The mean (SD) time from transplant to cancer diagnosis was 63.41 (37.10) months (range, 17-122 mo). The types of tumors were lung cancer, lymphoma, neuroendocrine tumor of lung, nasopharyngeal cancer, and squamous cell carcinoma of the skin. Seven cases received chemotherapy with or without radiotherapy. Two cases received surgery and radiotherapy. One patient underwent surgical treatment. One patient died before treatment was started.
In recent years, improvements in surgical techniques and immunosuppressive therapies have helped prolong survival of patients who undergo liver transplant. However, this also has led to a rise in the incidence of long-term complications such as de novo malignancy. These patients are more likely to develop de novo malignancy than the general population, for which chronic immunosuppression is identified as a major risk factor. Early diagnosis and treatment of de novo malignancies can help obtain better prognosis and higher survival rates in these patients.
我们的目的是分析肝移植后新发恶性肿瘤的特征、危险因素及发生率。
从新发恶性肿瘤发生的角度对557例行肝移植患者的医院记录进行分析。我们回顾性评估了这些患者的人口统计学特征和生存率。
该研究涵盖429例患者，其中9例（2%）发生了新发恶性肿瘤。所有这些患者均为男性（100%），其平均（标准差）年龄为51.33（4.69）岁（范围45 - 65岁）。移植指征包括酒精相关性4例、慢性乙型肝炎2例、慢性乙型和丙型肝炎1例、慢性乙型和丁型肝炎1例、慢性丙型肝炎和酒精性肝硬化1例。从移植到癌症诊断的平均（标准差）时间为63.41（37.10）个月（范围17 - 122个月）。肿瘤类型为肺癌、淋巴瘤、肺神经内分泌肿瘤、鼻咽癌和皮肤鳞状细胞癌。7例接受了化疗，有或没有放疗。2例接受了手术和放疗。1例患者接受了手术治疗。1例患者在开始治疗前死亡。
近年来，手术技术和免疫抑制疗法的改进有助于延长肝移植患者的生存期。然而，这也导致了诸如新发恶性肿瘤等长期并发症发生率的上升。这些患者比普通人群更易发生新发恶性肿瘤，慢性免疫抑制被确定为主要危险因素。对新发恶性肿瘤进行早期诊断和治疗有助于这些患者获得更好的预后和更高的生存率。
