Bernal Bellido Carmen, Suárez Artacho Gonzalo, Álamo Martínez José María, Marin Gómez Luis Miguel, Cepeda Franco Carmen, Barrera Pulido Lydia, Praena Fernández Juan Manuel, Padillo Ruiz Javier, Gómez Bravo Miguel Ángel
Hospital Universitario Virgen del Rocío, Sevilla, España.
Hospital Universitario Virgen del Rocío, Sevilla, España.
Cir Esp (Engl Ed). 2018 Oct;96(8):501-507. doi: 10.1016/j.ciresp.2018.05.003. Epub 2018 Jul 13.
The greater survival of transplanted patients is accompanied by an increase in the rate of de novo malignancies (NM), which are the most frequent late-onset complication. We can distinguish between non-melanoma skin cancers (NMSC), post-transplant lymphoproliferative disorders (PTLD) and solid organ cancers (SOC). Our objective is to determine the incidence of the different types of NM, the time elapsed until diagnosis and survival rates in our setting.
We conducted a retrospective study of 1071 liver transplant patients from 1990 to 2015 at our center. We analyzed the demographic variables, incidence of NM and survival.
184 NM developed in 1071 transplant patients (17%), specifically 19% of the males and 13% of the females (P=.004). The most frequent NM were NMSC (29%), lung (18%), head and neck (16%), PTLD (10%) and gastrointestinal (8%). The median time of diagnosis was 7.9 years in NMSC, 3.9 years in PTLD and 9.8 years in SOC. Patients with NMSC had significantly better survival than those with PTLD or SOC. The incidence of de novo tumors (excluding NMSC) was 1889/100,000 transplants/year. By gender, lung cancer was the most common TOS in men and breast cancer in women.
In our setting, excluding NMSC, the incidence is 8.8 times greater than estimations for the general population, with a high rate of lung cancer, so we should implement preventive and diagnostic strategies.
移植患者存活率的提高伴随着新发恶性肿瘤(NM)发生率的增加,NM是最常见的迟发性并发症。我们可以区分非黑色素瘤皮肤癌(NMSC)、移植后淋巴细胞增殖性疾病(PTLD)和实体器官癌(SOC)。我们的目标是确定在我们的研究环境中不同类型NM的发病率、诊断前的时间间隔和生存率。
我们对1990年至2015年在我们中心接受肝移植的1071例患者进行了回顾性研究。我们分析了人口统计学变量、NM的发病率和生存率。
1071例移植患者中发生了184例NM(17%),具体而言,男性为19%,女性为13%(P = 0.004)。最常见的NM是NMSC(29%)、肺癌(18%)、头颈癌(16%)、PTLD(10%)和胃肠道癌(8%)。NMSC的诊断中位时间为7.9年,PTLD为3.9年,SOC为9.8年。NMSC患者的生存率明显高于PTLD或SOC患者。新发肿瘤(不包括NMSC)的发病率为每年1889/10万次移植。按性别划分,肺癌是男性最常见的肿瘤,乳腺癌是女性最常见的肿瘤。
在我们的研究环境中,不包括NMSC,发病率比一般人群的估计值高8.8倍,肺癌发病率高,因此我们应实施预防和诊断策略。