#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
CS
proLékaře.cz / Journals / Perspectives in Surgery / 2020 - 10

Malignancy after lung transplantation

Czech version

Authors: M. Švorcová 1;  J. Havlín 1;  J. Vachtenheim 1;  J. Kolařík 1;  J. Pozniak 1;  J. Šimonek 1;  J. Burkert 2;  R. Lischke 1
Authors‘ workplace: III. chirurgická klinika 1. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Motol, Praha 1;  Klinika kardiovaskulární chirurgie 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Motol, Praha 2
Published in: Rozhl. Chir., 2020, roč. 99, č. 10, s. 447-455.
Category: Original articles

Overview

Introduction: Lung transplantation has become a successful life-saving treatment for patients with end-stage pulmonary disorders. Long-term survival outcomes after lung transplantation have been improving with increasing experience. Malignancies occupy the third position among the causes of death, particularly between years 5 to 10 from lung transplantation. The risk factors include predominantly high doses of immunosuppressive therapy, older age, infections caused by oncogenic viruses and smoking history.

Methods: We retrospectively evaluated all patients undergoing lung transplantation between 2010 and 2019. The aim of this study was to analyze the incidence, type and location of tumors, time from detection, survival time and cause of death in patients with malignant tumors after lung transplantation.

Results: In total, 308 lung transplantations were performed at the 3rd Department of Surgery of the 1st Faculty of Medicine, Charles University and University Faculty Hospital in Motol between 2010 and 2019. Posttransplant malignancy was diagnosed in 32 patients; a tumor was detected in the explanted lung in 5 patients. Lung cancer was the most frequent tumor in our study and was found in 13 patients (37%); 6 patients (17%) had a nonmelanoma skin cancer; and posttransplant proliferative disease developed in 4 patients (12.5%). The incidence rate of other types of malignancy was low. Mean of survival after diagnosis was 152 days.

Conclusion: Life time administration of immunosuppressive therapy in lung transplanted patients plays a key role in the prevention of rejection but on the other hand it represents a risk factor for cancer development. Oncological management of posttransplant cancer is based on reduction of immunosuppressive therapy, combined with surgical resection of solid organ tumors and other types of cancer therapy. Oncology screening tests should be done regularly as a method of prevention, and for an early detection of any tumor.

Keywords:

Lung transplantation

Sources
  1. Costa J, Benvenuto LJ, Sonett JR. Long-term outcomes and management of lung transplant recipients. Best Pract Res Clin Anaesthesiol. 2017;31(2):285–297. doi:10.1016/j.bpa.2017.05.006.
  2. Der Hovanessian A, Wallace WD, Lynch JP 3rd, et al. Chronic lung allograft dysfunction: Evolving concepts and therapies.Semin Respir Crit Care Med. 2018;39(2):155–171. doi:10.1055/s-0037-1618567.
  3. Olland AB, Falcoz PE, Santelmo N, et al. Primary lung cancer in lung transplant recipients. Ann Thorac Surg. 2014;98(1):362–371. doi:10.1016/j.athoracsur.2014.04.014.
  4. Yusen RD, Edwards LB, Kucheryavaya AY, et al. The registry of the International Society for Heart and Lung Transplantation: Thirty-second official adult lung and heart-lung transplantation report 2015; Focus theme: Early graft failure. J Heart Lung Transplant. 2015;34(10):1264–1277. doi:10.1016/j.healun.2015.08.014.
  5. Siegel RL, Miller KD, Jemal A. Cancer statistics 2020. CA Cancer J Clin. 2020;70(1):7–30. doi:10.3322/caac.21590.
  6. De Rosa N, Paddon VL, Liu Z, et al. Nonmelanoma skin cancer frequency and risk factors in Australian heart and lung transplant recipients. JAMA Dermatol. 2019;155(6):716–719. doi:10.1001/jamadermatol.2018.4789.
  7. Howard MD, Su JC, Chong AH. Skin cancer following solid organ transplantation: A review of risk factors and models of care. Am J Clin Dermatol. 2018;19(4):585–597. doi:10.1007/s40257-018-0355-8.
  8. Tanaka S, Chen-Yoshikawa TF, Hijiya K, et al. Characteristics of postoperative malignancies after lung transplantation. Kyobu Geka 2016;69(11):935–939.
  9. Pillai AA. Management of de novo malignancies after liver transplantation. Transplant Rev. (Orlando) 2015;29(1):38–41. doi:10.1016/j.trre.2014.11.002.
  10. Buell JF, Gross TG, Woodle ES. Malignancy after transplantation. Transplantation 2005;80(2 Suppl):S254–S264. doi:10.1097/01.tp.0000186382.81130.ba.
  11. Christie JD, Edwards LB, Aurora P, et al. The registry of the International Society for Heart and Lung Transplantation: Twenty-sixth official adult lung and heart-lung transplantation report 2009. J Heart Lung Transplant 2009;28(10):1031–1049. doi:10.1016/j.healun.2009.08.004.
  12. Kahan BD, Yakupoglu YK, Schoenberg L, et al. Low incidence of malignancy among sirolimus/cyclosporine-treated renal transplant recipients. Transplantation 2005;80(6):749–758. doi:10.1097/01.tp.0000173770.42403.f7.
  13. Pascual J, Fernández AM, Marcén R, et al. Conversion to everolimus in a patient with arterial hypertension and recurrent cutaneous neoplasia – a case report. Nephrol Dial Transplant. 2006;21 Suppl3:iii38–iii41. doi:10.1093/ndt/gfl299.
  14. Fernández A, Marcén R, Pascual J, et al. Conversion from calcineurin inhibitors to everolimus in kidney transplant recipients with malignant neoplasia. Transplant Proc. 2006;38(8):2453–2455. doi:10.1016/j.transproceed.2006.08.016.
  15. Chiurchiu C, Carreño CA, Schiavelli R, et al. Results of the conversion to everolimus in renal transplant recipients with posttransplantation malignancies. Transplant Proc. 2010;42(1):277–279. doi:10.1016/j.transproceed.2009.11.017.
  16. Gutierrez-Dalmau A, Campistol JM. Immunosuppressive therapy and malignancy in organ transplant recipients: a systematic review. Drugs 2007;67(8):1167–1198. doi:10.2165/00003495-200767080-00006.
  17. Marcén R. Immunosuppressive drugs in kidney transplantation: impact on patient survival, and incidence of cardiovascular disease, malignancy and infection. Drugs 2009;69(16):2227–2243. doi:10.2165/11319260-000000000-00000.
  18. Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med. 2003;348(17):1681–1691. doi:10.1056/NEJMra022137.
  19. Ingvar A, Smedby KE, Lindelöf B, et al. Immunosuppressive treatment after solid organ transplantation and risk of post-transplant cutaneous squamous cell carcinoma. Nephrol Dial Transplant. 2010;25(8):2764–2771. doi:10.1093/ndt/gfp425.
  20. Ducloux D, Carron PL, Rebibou JM, et al. CD4 lymphocytopenia as a risk factor for skin cancers in renal transplant recipients. Transplantation 1998;65(9):1270–1272. doi:10.1097/00007890-199805150-00022.
  21. Gjersvik P, Helsing P, Holdaas H, et al. Immunsuppressive legemidler og utvikling av hudkreft etter organ transplantasjon [Immunosuppressive drugs and the development of skin cancer after organ transplantation]. Tidsskr Nor Laegeforen 2012;132(18):2064–2068. doi:10.4045/tidsskr.12.0389.
  22. Garrett GL, Blanc PD, Boscardin J, et al. Incidence of and risk factors for skin cancer in organ transplant recipients in the United States [published correction appears in JAMA Dermatol. 2017;153(3):357]. JAMA Dermatol 2017;153(3):296–303. doi:10.1001/jamadermatol.2016.4920.
  23. Martinez OM, Krams SM. The immune response to Epstein Barrvirus and implications for posttransplant lymphoproliferative disorder. Transplantation 2017;101(9):2009–2016. doi:10.1097/TP.0000000000001767.
  24. Parker A, Bowles K, Bradley JA, et al. Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients – BCSH and BTS Guidelines. Br J Haematol. 2010;149(5):693–705. doi:10.1111/j.1365-2141.2010.08160.x.
  25. Singavi AK, Harrington AM, Fenske TS. Post-transplant lymphoproliferative disorders. Cancer Treat Res. 2015;165:305–327. doi:10.1007/978-3-319-13150-4_13.
  26. Hirama T, Tikkanen J, Pal P, et al. Epstein-Barr virus-associated smooth muscle tumors after lung transplantation. Transpl Infect Dis. 2019;21(3):e13068. doi:10.1111/tid.13068.
  27. Dharnidharka VR. Comprehensive review of post-organ transplant hematologic cancers. Am J Transplant. 2018;18(3):537–549. doi:10.1111/ajt.14603.
  28. Desai R, Collett D, Watson CJ, et al. Estimated risk of cancer transmission from organ donor to graft recipient in a national transplantation registry. Br J Surg. 2014;101(7):768–774. doi:10.1002/bjs.9460.
  29. de Perrot M, Fischer S, Waddell TK, et al. Management of lung transplant recipients with bronchogenic carcinoma in the native lung. J Heart Lung Transplant. 2003;22(1):87–89. doi:10.1016/s1053-2498(02)00446-1.
  30. Dickson RP, Davis RD, Rea JB, et al. High frequency of bronchogenic carcinoma after single-lung transplantation. J Heart Lung Transplant. 2006;25(11):1297–1301. doi:10.1016/j.healun.2006.09.009.
  31. 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.
  32. Ewald DR, Sumner SC. Blood type biochemistry and human disease. Wiley Interdiscip Rev Syst Biol Med. 2016;8(6):517–535. doi:10.1002/wsbm.1355.
Labels
Surgery Orthopaedics Trauma surgery
Role of extracorporeal life support in thoracic surgery
Postoperative chylothorax − review
Treatment of anastomotic leak after Ivor Lewis esophagectomy
Hyperthermic intraoperative intrapleural chemotherapy and surgical cytoreduction as part of multimodal treatment of malignant pleural mesothelioma – case report M. Szkorupa1, D. Klos1, J. Chudacek1, J. Hanuliak1, M. Stasek1, O. Fischer2, R. Lemstrova3
Pulmonary metastases in pseudomyxoma peritonei – case report and review of the literature
Pulmonary arteriovenous malformation managed by VATS lobectomy
Minimalizace a maximalizace v hrudní chirurgii
Article was published in

Perspectives in Surgery

Issue 10
2020 Issue 10
Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#