Early and Late De Novo Tumors after Liver Transplantation in Adults: The Late Onset of Bladder Tumors in Men

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Abstract

Background:De novo tumors (DNT) after liver transplantation (LT) represent a growing concern.Patients and Methods:We analyzed the incidence of DNT, type, time of onset, risk factors and mortality (as of 2010) in 494 adult patients transplanted in the last 26 years (1983-2009).Results:DNT occurred in 41 (8.3%) of the patients. The Standardized Incidence Ratio (SIR) compared with the Italian population was 1.8. There was a higher incidence in males (SIR 2.0), an expected extremely high rate of Kaposi's sarcoma (SIR 127.95) and unexpected higher rates of tumors of the bladder in males (SIR 3.3). The incidence of DNT was higher within the first two years of LT (SIR 2.7) for Kaposi's sarcoma (SIR 393.3) and after 10 years (SIR 1.7) for bladder tumors (SIR 10.6). Multivariate analysis identified alcoholic cirrhosis (HR = 3.0, 95% CI = 1.2-7.8) and sclerosing cholangitis (HR = 3.5, 95% CI = 1.1-11.3) in the recipient as main risk factors for the occurrence of DNT.Conclusions:Surveillance protocols for DNT must be specifically oriented to patients transplanted for alcoholic cirrhosis and sclerosing cholangitis. They should focus on early detection of Kaposi's sarcomas, and more remarkably, on late development bladder tumors in men after LT.

Original languageEnglish
Article numbere65238
JournalPLoS One
Volume8
Issue number6
DOIs
Publication statusPublished - Jun 13 2013

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liver transplant
Urinary Bladder Neoplasms
Liver
Liver Transplantation
Tumors
incidence
neoplasms
Incidence
Neoplasms
Kaposi's Sarcoma
sarcoma
Alcoholic Liver Cirrhosis
Sclerosing Cholangitis
alcohol abuse
urinary bladder neoplasms
risk factors
multivariate analysis
Multivariate Analysis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

@article{3a656e47e6e94e629ecf9b0b6e9841ce,
title = "Early and Late De Novo Tumors after Liver Transplantation in Adults: The Late Onset of Bladder Tumors in Men",
abstract = "Background:De novo tumors (DNT) after liver transplantation (LT) represent a growing concern.Patients and Methods:We analyzed the incidence of DNT, type, time of onset, risk factors and mortality (as of 2010) in 494 adult patients transplanted in the last 26 years (1983-2009).Results:DNT occurred in 41 (8.3{\%}) of the patients. The Standardized Incidence Ratio (SIR) compared with the Italian population was 1.8. There was a higher incidence in males (SIR 2.0), an expected extremely high rate of Kaposi's sarcoma (SIR 127.95) and unexpected higher rates of tumors of the bladder in males (SIR 3.3). The incidence of DNT was higher within the first two years of LT (SIR 2.7) for Kaposi's sarcoma (SIR 393.3) and after 10 years (SIR 1.7) for bladder tumors (SIR 10.6). Multivariate analysis identified alcoholic cirrhosis (HR = 3.0, 95{\%} CI = 1.2-7.8) and sclerosing cholangitis (HR = 3.5, 95{\%} CI = 1.1-11.3) in the recipient as main risk factors for the occurrence of DNT.Conclusions:Surveillance protocols for DNT must be specifically oriented to patients transplanted for alcoholic cirrhosis and sclerosing cholangitis. They should focus on early detection of Kaposi's sarcomas, and more remarkably, on late development bladder tumors in men after LT.",
author = "Umberto Maggi and Dario Consonni and Manini, {Matteo Angelo} and Stefano Gatti and Francesco Cuccaro and Francesca Donato and Grazia Conte and Bertazzi, {Pier Alberto} and Giorgio Rossi",
year = "2013",
month = "6",
day = "13",
doi = "10.1371/journal.pone.0065238",
language = "English",
volume = "8",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - Early and Late De Novo Tumors after Liver Transplantation in Adults

T2 - The Late Onset of Bladder Tumors in Men

AU - Maggi, Umberto

AU - Consonni, Dario

AU - Manini, Matteo Angelo

AU - Gatti, Stefano

AU - Cuccaro, Francesco

AU - Donato, Francesca

AU - Conte, Grazia

AU - Bertazzi, Pier Alberto

AU - Rossi, Giorgio

PY - 2013/6/13

Y1 - 2013/6/13

N2 - Background:De novo tumors (DNT) after liver transplantation (LT) represent a growing concern.Patients and Methods:We analyzed the incidence of DNT, type, time of onset, risk factors and mortality (as of 2010) in 494 adult patients transplanted in the last 26 years (1983-2009).Results:DNT occurred in 41 (8.3%) of the patients. The Standardized Incidence Ratio (SIR) compared with the Italian population was 1.8. There was a higher incidence in males (SIR 2.0), an expected extremely high rate of Kaposi's sarcoma (SIR 127.95) and unexpected higher rates of tumors of the bladder in males (SIR 3.3). The incidence of DNT was higher within the first two years of LT (SIR 2.7) for Kaposi's sarcoma (SIR 393.3) and after 10 years (SIR 1.7) for bladder tumors (SIR 10.6). Multivariate analysis identified alcoholic cirrhosis (HR = 3.0, 95% CI = 1.2-7.8) and sclerosing cholangitis (HR = 3.5, 95% CI = 1.1-11.3) in the recipient as main risk factors for the occurrence of DNT.Conclusions:Surveillance protocols for DNT must be specifically oriented to patients transplanted for alcoholic cirrhosis and sclerosing cholangitis. They should focus on early detection of Kaposi's sarcomas, and more remarkably, on late development bladder tumors in men after LT.

AB - Background:De novo tumors (DNT) after liver transplantation (LT) represent a growing concern.Patients and Methods:We analyzed the incidence of DNT, type, time of onset, risk factors and mortality (as of 2010) in 494 adult patients transplanted in the last 26 years (1983-2009).Results:DNT occurred in 41 (8.3%) of the patients. The Standardized Incidence Ratio (SIR) compared with the Italian population was 1.8. There was a higher incidence in males (SIR 2.0), an expected extremely high rate of Kaposi's sarcoma (SIR 127.95) and unexpected higher rates of tumors of the bladder in males (SIR 3.3). The incidence of DNT was higher within the first two years of LT (SIR 2.7) for Kaposi's sarcoma (SIR 393.3) and after 10 years (SIR 1.7) for bladder tumors (SIR 10.6). Multivariate analysis identified alcoholic cirrhosis (HR = 3.0, 95% CI = 1.2-7.8) and sclerosing cholangitis (HR = 3.5, 95% CI = 1.1-11.3) in the recipient as main risk factors for the occurrence of DNT.Conclusions:Surveillance protocols for DNT must be specifically oriented to patients transplanted for alcoholic cirrhosis and sclerosing cholangitis. They should focus on early detection of Kaposi's sarcomas, and more remarkably, on late development bladder tumors in men after LT.

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