TY - JOUR
T1 - Survival after the diagnosis of de novo malignancy in liver transplant recipients
AU - Taborelli, Martina
AU - Piselli, Pierluca
AU - Ettorre, Giuseppe Maria
AU - Baccarani, Umberto
AU - Burra, Patrizia
AU - Lauro, Augusto
AU - Galatioto, Laura
AU - Rendina, Maria
AU - Shalaby, Sarah
AU - Petrara, Raffaella
AU - Nudo, Francesco
AU - Toti, Luca
AU - Fantola, Giovanni
AU - Cimaglia, Claudia
AU - Agresta, Alessandro
AU - Vennarecci, Giovanni
AU - Pinna, Antonio Daniele
AU - Gruttadauria, Salvatore
AU - Risaliti, Andrea
AU - Di Leo, Alfredo
AU - Rossi, Massimo
AU - Tisone, Giuseppe
AU - Zamboni, Fausto
AU - Serraino, Diego
PY - 2018/8/9
Y1 - 2018/8/9
N2 - © 2018 UICC 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.
AB - © 2018 UICC 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.
KW - immunosuppression
KW - Italy
KW - liver transplant
KW - malignancy
KW - nested case–control study
KW - survival
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U2 - 10.1002/ijc.31782
DO - 10.1002/ijc.31782
M3 - Article
AN - SCOPUS:85055695128
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
ER -