| Autor: |
Taborelli, Martina, Piselli, Pierluca, Ettorre, Giuseppe Maria, Baccarani, Umberto, Burra, Patrizia, Lauro, Augusto, Galatioto, Laura, Rendina, Maria, Shalaby, Sarah, Petrara, Raffaella, Nudo, Francesco, Toti, Luca, Fantola, Giovanni, Cimaglia, Claudia, Agresta, Alessandro, Vennarecci, Giovanni, Pinna, Antonio Daniele, Gruttadauria, Salvatore, Risaliti, Andrea, Di Leo, Alfredo |
| Zdroj: |
International Journal of Cancer; Jan2019, Vol. 144 Issue 2, p232-239, 8p |
| Abstrakt: |
In the setting of liver transplant (LT), the survival after the diagnosis of de novo malignancies (DNMs) has been poorly investigated. In this study, we assessed the impact of DNMs on survival of LT recipients as compared to corresponding LT recipients without DNM. A nested case–control study was conducted in a cohort of 2,818 LT recipients enrolled in nine Italian centres between 1985 and 2014. Cases were 244 LT recipients who developed DNMs after LT. For each case, two controls matched for gender, age, and year at transplant were selected by incidence density sampling among cohort members without DNM. The survival probabilities were estimated using the Kaplan–Meier method. Hazard ratios (HRs) of death and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models. The all‐cancer 10‐year survival was 43% in cases versus 70% in controls (HR = 4.66; 95% CI: 3.17–6.85). Survival was impaired in cases for all the most frequent cancer types, including lung (HR = 37.13; 95% CI: 4.98–276.74), non‐Hodgkin lymphoma (HR = 6.57; 95% CI: 2.15–20.01), head and neck (HR = 4.65; 95% CI: 1.81–11.95), and colon‐rectum (HR = 3.61; 95% CI: 1.08–12.07). The survival gap was observed for both early and late mortality, although the effect was more pronounced in the first year after cancer diagnosis. No significant differences in survival emerged for Kaposi's sarcoma and nonmelanoma skin cancers. The survival gap herein quantified included a broad range of malignancies following LT and prompts close monitoring during the post‐transplant follow‐up to ensure early cancer diagnosis and to improve survival. What's new? Solid‐organ transplant recipients are at higher risk of developing several cancer types compared with the general population. The prognostic impact of de novo malignancies (DNMs) in these patients remain poorly investigated, however. This study shows the detrimental effect of DNMs on survival of liver transplant (LT) recipients as compared to matched LT recipients without DNM. The all‐cancer 10‐year survival was 43% versus 70% in controls. This pattern was consistent for all the most frequent cancer types, except Kaposi's sarcoma and nonmelanoma skin cancer. The findings call for close post‐transplant follow‐up to detect tumors at earlier stages when treatments are more effective. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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