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肝移植术后新发恶性肿瘤:高容量中心的经验

De Novo Malignancies After Liver Transplantation: Experience of a High-Volume Center.

作者信息

Saglam Kutay, Sahin Tevfik Tolga, Ogut Zeki, Ince Volkan, Usta Sertac, Yilmaz Sezai

机构信息

Department of Gastrointestinal Surgery, Liver Transplantation Institute, Inonu University School of Medicine, 44315, Malatya, Turkey.

Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey.

出版信息

J Gastrointest Cancer. 2022 Dec;53(4):1020-1027. doi: 10.1007/s12029-021-00749-0. Epub 2021 Nov 14.

DOI:10.1007/s12029-021-00749-0
PMID:34778909
Abstract

PURPOSE

Patient care, newer immunosuppressive medications, and advances in surgical technique, have resulted in significant prolongation of survival after liver transplantation in recent years. However, as life expectancy increased and the early mortality rates have decreased, different problems have evolved due to chronic immunosuppressive therapy. The aim of the present study is to evaluate patients who were transplanted and then developed de novo malignancies, in terms of the type of malignancies and the follow-up period.

METHODS

The study was conducted on 2814 patients who received liver transplantation between 2008 and 2020 in Inonu University Liver Transplant Institute. In total, the data of 23 patients were evaluated retrospectively.

RESULTS

Non-melanoma skin cancer was the most common de novo malignancy (21.7%), followed by gynecological cancers (17.3%). The interval between the time of transplantation until the development of de novo malignancy was 36 (6-75) months. The median follow-up period after the diagnoses of the de novo malignancies was 4.11 years. One, 3-, 5-year survival rates of patients after the diagnoses of de novo malignancies were 69.6%, 56.5%, and 41.9%; respectively.

CONCLUSION

Non-melanotic skin cancers were the most common de novo cancers in liver transplant recipients. A strict surveillance program is very important in the follow-up of liver transplant recipients.

摘要

目的

近年来,患者护理、新型免疫抑制药物以及手术技术的进步显著延长了肝移植后的生存期。然而,随着预期寿命的增加和早期死亡率的降低,慢性免疫抑制治疗引发了不同的问题。本研究的目的是从恶性肿瘤类型和随访时间方面评估肝移植后发生新发恶性肿瘤的患者。

方法

本研究对2008年至2020年间在伊诺努大学肝移植研究所接受肝移植的2814例患者进行。总共对23例患者的数据进行了回顾性评估。

结果

非黑色素瘤皮肤癌是最常见的新发恶性肿瘤(21.7%),其次是妇科癌症(17.3%)。从移植到发生新发恶性肿瘤的间隔时间为36(6 - 75)个月。新发恶性肿瘤诊断后的中位随访时间为4.11年。新发恶性肿瘤诊断后患者的1年、3年、5年生存率分别为69.6%、56.5%和41.9%。

结论

非黑色素瘤皮肤癌是肝移植受者中最常见的新发癌症。严格的监测计划在肝移植受者的随访中非常重要。

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Association between Immunosuppressive Therapy Utilized in the Treatment of Autoimmune Disease or Transplant and Cancer Progression.用于治疗自身免疫性疾病或移植的免疫抑制疗法与癌症进展之间的关联。
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本文引用的文献

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Upper Gastrointestinal Tract Cancer after Liver Transplantation: A Demographic Report.肝移植术后上消化道癌:一份人口统计学报告。
Int J Organ Transplant Med. 2020;11(2):71-80.
2
malignancies after liver transplantation: The effect of immunosuppression-personal data and review of literature.肝移植后的恶性肿瘤:免疫抑制的影响——个人数据和文献回顾。
World J Gastroenterol. 2019 Sep 21;25(35):5356-5375. doi: 10.3748/wjg.v25.i35.5356.
3
Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States.
美国器官移植受者皮肤癌的发病率和危险因素。
JAMA Dermatol. 2017 Mar 1;153(3):296-303. doi: 10.1001/jamadermatol.2016.4920.
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De Novo Malignancies After Transplantation: Risk and Surveillance Strategies.移植后新发恶性肿瘤:风险与监测策略
Med Clin North Am. 2016 May;100(3):551-67. doi: 10.1016/j.mcna.2016.01.006. Epub 2016 Mar 17.
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De Novo Malignancies After Liver Transplantation With 14 Cases at a Single Center.肝移植术后新发恶性肿瘤:单中心14例报告
Transplant Proc. 2015 Oct;47(8):2483-7. doi: 10.1016/j.transproceed.2015.08.008.
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Post-transplant lymphoproliferative disorders.移植后淋巴增殖性疾病
Cancer Treat Res. 2015;165:305-27. doi: 10.1007/978-3-319-13150-4_13.
7
Skin cancers after liver transplantation: retrospective single-center study on 371 recipients.肝移植术后皮肤癌:371 例患者回顾性单中心研究。
Transplantation. 2014 Aug 15;98(3):335-40. doi: 10.1097/TP.0000000000000051.
8
De novo malignancies after adult-to-adult living-donor liver transplantation with a malignancy surveillance program: comparison with a Japanese population-based study.成人对成人活体肝移植后恶性肿瘤监测计划中的新发恶性肿瘤:与日本基于人群的研究比较。
Transplantation. 2013 May 15;95(9):1142-7. doi: 10.1097/TP.0b013e318288ca83.
9
De novo malignancies after liver transplantation: incidence comparison with the Korean cancer registry.肝移植术后新发恶性肿瘤:与韩国癌症登记处的发病率比较。
Transplant Proc. 2012 Apr;44(3):802-5. doi: 10.1016/j.transproceed.2012.01.027.
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Evolution of causes and risk factors for mortality post-liver transplant: results of the NIDDK long-term follow-up study.肝移植后死亡率的病因和风险因素的演变:NIDDK 长期随访研究的结果。
Am J Transplant. 2010 Jun;10(6):1420-7. doi: 10.1111/j.1600-6143.2010.03126.x. Epub 2010 May 10.