Catelli Chiara, Faccioli Eleonora, Silvestrin Stefano, Lorenzoni Giulia, Luzzi Luca, Bennett David, Schiavon Marco, Campisi Alessio, Bargagli Elena, Dell'Amore Andrea, Rea Federico
Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
Unit of Biostatistics Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35121 Padova, Italy.
Cancers (Basel). 2024 Jan 26;16(3):538. doi: 10.3390/cancers16030538.
The accurate selection of the recipient is a crucial aspect in the field of lung transplantation (LTX), especially if patients were previously affected by oncological disease. The aim of this bicentric retrospective study was to evaluate short- and long-term outcomes in patients with previous oncological disease or unknown neoplasia found on native lungs submitted to LTX, compared to a control group. A total of 433 patients were included in the analysis, 31 with malignancies (Group 1) and 402 without neoplastic disease (Group 2). The two groups were compared in terms of short- and long-term outcomes. Patients in Group 1 were older (median age 58 years vs. 50 years, = 0.039) and mostly affected by idiopathic pulmonary fibrosis (55% vs. 40% = 0.002). Even though in Group 1 a lower rate of late post-operative complications was found (23% vs. 45%, = 0.018), the median overall survival (OS) was lower compared to the control group (10 months vs. 29 months, = 0.015). LTX represents a viable therapeutic option for patients with end-stage lung disease and a history of neoplastic disease. However, every case should be carefully debated in a multidisciplinary setting, considering oncological (histology, stage, and proper disease free-interval) and clinical factors (patient's age and comorbidities). A scrupulous post-transplant follow-up is especially mandatory in those cases.
准确选择受者是肺移植（LTX）领域的一个关键方面，特别是对于先前患有肿瘤疾病的患者。这项双中心回顾性研究的目的是评估与对照组相比，接受LTX的患者中，那些先前患有肿瘤疾病或在其天然肺上发现不明肿瘤的患者的短期和长期预后。共有433例患者纳入分析，31例患有恶性肿瘤（第1组），402例无肿瘤疾病（第2组）。比较两组的短期和长期预后。第1组患者年龄较大（中位年龄58岁对50岁，P = 0.039），且大多患有特发性肺纤维化（55%对40%，P = 0.002）。尽管在第1组中发现术后晚期并发症的发生率较低（23%对45%，P = 0.018），但其总生存期中位数（OS）低于对照组（10个月对29个月，P = 0.015）。LTX对于患有终末期肺病且有肿瘤疾病史的患者是一种可行的治疗选择。然而，每一个病例都应在多学科环境中仔细讨论，考虑肿瘤学因素（组织学、分期和适当的无病间期）和临床因素（患者年龄和合并症）。在这些病例中，严格的移植后随访尤为必要。
