Colorectal carcinoma after liver transplantation
Authors:
Jungwirth J. 1,2; P. Mačinga 1; J. Král 1; P. Taimr 1; J. Froněk 3; J. Špičák 1; T. Hucl 1
Authors‘ workplace:
Klinika hepatogastroenterologie, IKEM, Praha
1; Klinik für Allgemein, Thorax und Visceralchirurgiechirurgie, Klinikum Weiden
2; Klinika transplantační chirurgie, IKEM, Praha
3
Published in:
Gastroent Hepatol 2022; 76(4): 302-308
Category:
Clinical and Experimental Gastroenterology: Review Article
doi:
https://doi.org/10.48095/ccgh2022302
Overview
Introduction: Patients after liver transplantation (LTx) have an increased risk of developing malignancies, especially skin malignancies and lymphomas. Colorectal cancer is one of the most common malignancies, its incidence may be higher after transplantation of certain organs. In liver transplant patients, the risk of developing CRC is not clearly known. Aim and methods: The aim of this work was to evaluate the incidence of CRC in patients after liver transplantation and to enrich these data with our own experience from our transplant center. Results: In the literature, the documented incidence of colorectal cancer ranges from comparable to twice as high, compared to the general population. Most studies evaluate incidence of different tumors after transplantatin of various organs irrespective of the indication for transplantation. An unequivocally proven risk factor is the presence of primary sclerosing cholangitis by ulcerative colitis, which is, however, a precancer in itself. Studies in which non-PSC and UC liver transplant recipients were evaluated separately mostly did not show an increased risk of CRC. Conclusion: According to most studies, the incidence of colorectal cancer in all liver transplant patients is slightly higher than in the general population. The risk of PSC/UC in liver transplant patients is significantly higher, which strongly supports the necessity of their regular endoscopic surveillance. In patients transplanted for other indications, the risk of developing CRC seems comparable with the general population. Posttransplant CRC is characterized by location in the right colon, diagnosis at a later stage and worse prognosis.
Keywords:
Transplantation – liver transplantion– colorectal carcinoma
Sources
1. Haagsma EB, Hagens VE, Schaapveld M et al. Increased cancer risk after liver ůtransplantation: a population-based study. J Hepatol 2001; 34 (1): 84–91. doi: 10.1016/s0168-8278 (00) 00077-5.
2. Fung JJ, Jain A, Kwak EJ et al. De novo malignancies after liver transplantation: a major cause of late death. Liver Transpl 2001; 7 (11 Suppl 1): 109–118. doi: 10.1053/jlts.2001.28645.
3. Rocha A, Malheiro J, Fonseca I et al. Noncutaneous neoplasms after kidney transplantation: Analysis at single center. Transplantation Proc 2013; 45 (3): 1102–1105. doi: 10.1016/ j.transproceed.2013.02.005.
4. International agency for research on Cancer, Global cancer observatory. Globocan. 2018 [online]. Available from: https: //gco.iarc.fr/today/data/ factsheets/cancers/39-All-cancers-fact-sheet.
5. Engels EA, Pfeiffer RM, Fraumeni JF Jr et al. Spectrum of cancer risk among US solid organ transplant recipients. JAMA 201; 306 (17): 1891–1901. doi: 10.1001/jama.2011.1592.
6. Clarke WT, Feuerstein JD. Colorectal cancer surveillance in inflammatory bowel disease: Practice guidelines and recent developments. World J Gastroenterol 2019; 25 (30): 4148–4157. doi: 10.3748/wjg.v25.i30.4148.
7. Silva MA, Jambulingam PS, Mirza DF. Colorectal cancer after orthotopic liver transplantation. Crit Rev Oncol Hematol 2005; 56 (1): 147–153. doi: 10.1016/j.critrevonc.2004.12.013.
8. F. Aigner, E. Boeckle, J. Albright et al. Malignancies of the colorectum and anus in solid organ recipients. Transplant Int 2007; 20 (6): 497–504. 10.1111/j.1432-2277.2007.00 469.x.
9. Merchea A, Abdelsattar ZM, Taner T et al. Outcomes of colorectal cancer arising in solid organ transplant recipients. J Gastrointest Surg 2014; 18 (3): 599–604. doi: 10.1007/s11605-013-2402-3. doi: 10.1007/s11605-013-2402-3.
10. Merchea A, Shahjehan F, Croome KP et al. Colorectal Cancer characteristics and outcomes after solid organ transplantation. J Oncol 2019: 5796108. doi: 10.1155/2019/5796108.
11. Rompianesi G, Ravikumar R, Jose S et al. Incidence and outcome of colorectal cancer in liver transplant recipients: A national, multicentre analysis on 8115 patients. Liver Int 2019; 39 (2): 353–360. doi: 10.1111/liv.13947.
12. Nicolaas JS, De Jongea V, Steyerbergb EW et al. Risk of colorectal carcinoma in post‐liver transplant patients: a systematic review and meta-analysis. Am J Transplant 2010; 10: 868– 876. doi: 10.1111/j.1600-6143.2010.03049.x.
13. Kang EA, Koh S, Kim JW et al. Prevalence of advanced colorectal neoplasm is higher in liver transplant recipients. Turk J Gastroenterol 2018; 29 (3): 316–324. doi: 10.5152/tjg.2018.17 458.
14. Sint Nicolaas J, Tjon ASW, Metselaar HJ et al. Colorectal cancer in post-liver transplant recipients. Dis Colon Rectum 2010; 53 (5): 817–821. doi: 10.1007/DCR.0b013e3181cc90c7.
15. Adami J, Gäbel H, Lindelöf B et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer 2003; 89 (7): 1221–1227. doi: 10.1038/sj.bjc.6601219.
15. Huo Z, Li C, Xu X et al. Cancer Risks in Solid Organ Transplant Recipients: Results from a Comprehensive Analysis of 72 Cohort Studies. Oncoimmunology 2020; 9 (1): 1848068. doi: 10.1080/2162402X.2020.1848068.
17. Selgrad M, Koornstra JJ, Fini L et al. JC virus infection in colorectal neoplasia that develops after liver transplantation. Clin Cancer Res 2008; 14 (20): 6717–6721. doi: 10.1158/1078-0432.CCR-08-0961.
18. Waldner M, Schimanski CC, Neurath MF. Colon cancer and the immune system: the role of tumor invading T cells. World J Gastroenterol 2006; 12 (45): 7233–7238. doi: 10.3748/wjg.v12.i45.7233.
19. Krynska B, Gordon J, Otte J et al. Role of cell cycle regulators in tumor formation in transgenic mice expressing the human neurotropic virus, JCV, early protein. J Cell Biochem 1997; 67: 223–230. doi: 10.1002/ (sici) 1097-4644 (19971101) 67: 2<223:: aid-jcb7>3.0.co; 2-z.
20. Dyson N, Bernards R, Friend SH et al. Large T antigens of many polyomaviruses are able to form complexes with the retinoblastoma protein. J Virol 1990; 64: 1353–1356. doi: 10.1128/JVI.64.3.1353-1356.1990.
21. Enam S, Del VL, Lara C et al. Association of human polyomavirus JCV with colon cancer: evidence for interaction of viral T-antigen and h-catenin. Cancer Res 2002; 62: 7093.
22. Goel A, Li MS, NagasakaT et al. Association of JC virusT-antigen expression with the methylator phenotype in sporadic colorectal cancers. Gastroenterology 2006; 130: 1950–1961. doi: 10.1053/j.gastro.2006.02.061.
23. Carenco C, Faure S, Herrero A et al. Incidence of solid organ cancers after liver transplantation: Comparison with regional cancer incidence rates and risk factors. Liver Int 2015; 35 (6): 1748–1755. doi: 10.1111/liv.12758.
24. Albright JB, Bonatti H, Stauffer J et al. Colorectal and anal neoplasms following liver transplantation. Colorectal Dis 2010; 12 (7): 657–666. doi: 10.1111/j.1463-1318.2009.01840.x.
25. Safaeian M, Robbins HA, Berndt SI et al. Risk of Colorectal Cancer After Solid Organ Transplantation in the United States. Am J Transplant 2016; 16 (3): 960–967. doi: 10.1111/ajt.13549. doi: 10.1111/ajt.13549.
26. Johnson EE, Leverson GE, Pirsch JD et al. A 30-year analysis of colorectal adenocarcinoma in transplant recipients and proposal for altered screening. J Gastrointest Surg 2007; 11 (3): 272–279. doi: 10.1007/s11605-007-0084-4.
27. Atassi T, Thuluvath PJ. Risk of colorectal adenoma in liver transplant recipients compared to immunocompetent control population undergoing routine screening colonoscopy. J Clin Gastroenterol 2003; 37 (1): 72–73. doi: 10.1097/00004836-200307000-00018.
28. Kim M, Kim CW, Hwang S et al. Characteristics and Prognosis of Colorectal Cancer after Liver or Kidney Transplantation. World J Surg 2021; 45 (10): 3206–3213. doi: 10.1007/s00 268-021-06219-9.
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