Gitto Stefano, Magistri Paolo, Marzi Luca, Mannelli Nicolò, De Maria Nicola, Mega Andrea, Vitale Giovanni, Valente Giovanna, Vizzutti Francesco, Villa Erica, Marra Fabio, Andreone Pietro, Falcini Margherita, Catellani Barbara, Guerrini Gian Piero, Serra Valentina, Di Sandro Stefano, Ballarin Roberto, Piai Guido, Schepis Filippo, Margotti Marzia, Cursaro Carmela, De Simone Paolo, Petruccelli Stefania, Carrai Paola, Forte Paolo, Campani Claudia, Zoller Heinz, Di Benedetto Fabrizio
Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, University Hospital Careggi, University of Florence, Largo Brambilla 3, Florence 50134, Italy.
Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Ann Hepatol. 2022 May-Jun;27(3):100683. doi: 10.1016/j.aohep.2022.100683. Epub 2022 Feb 10.
De novo malignancies represent an important cause of death for liver transplant recipients. Our aim was to analyze predictors of extra-hepatic non-skin cancer (ESNSC) and the impact of ESNSC on the long-term outcome.
We examined data from patients transplanted between 2000 and 2005 and followed-up in five Italian transplant clinics with a retrospective observational cohort study. Cox Regression was performed to identify predictors of ESNSC. A 1:2 cohort sub-study was developed to analyze the impact of ESNSC on 10-year survival.
We analyzed data from 367 subjects (median follow-up: 15 years). Patients with ESNSC (n = 47) more often developed post-LT diabetes mellitus (DM) (57.4% versus 35,9%, p = 0.004). At multivariate analysis, post-LT DM independently predicted ESNSC (HR 1.929, CI 1.029-3.616, p = 0.040). Recipients with ESNSC showed a lower 10-year survival than matched controls (46,8% versus 68,1%, p = 0.023).
Post-LT DM seems to be a relevant risk factor for post-LT ESNSC. ESNSC could have a noteworthy impact on the long-term survival of LT recipients.
新发恶性肿瘤是肝移植受者重要的死亡原因。我们的目的是分析肝外非皮肤癌（ESNSC）的预测因素以及ESNSC对长期预后的影响。
我们对2000年至2005年间接受移植并在意大利五家移植诊所进行随访的患者数据进行了回顾性观察队列研究。采用Cox回归分析确定ESNSC的预测因素。开展了一项1:2队列亚研究，以分析ESNSC对10年生存率的影响。
我们分析了367名受试者的数据（中位随访时间：15年）。发生ESNSC的患者（n = 47）更常发生肝移植后糖尿病（DM）（57.4%对35.9%，p = 0.004）。多因素分析显示，肝移植后DM是ESNSC的独立预测因素（HR 1.929，CI 1.029 - 3.616，p = 0.040）。发生ESNSC的受者10年生存率低于匹配的对照组（46.8%对68.1%，p = 0.023）。
肝移植后DM似乎是肝移植后ESNSC的一个相关危险因素。ESNSC可能对肝移植受者的长期生存产生显著影响。
