Pretransplant Hepatic Malignancy Increases Risk of De Novo Malignancy after Liver Transplantation
- Author:
Gil Chun PARK
1
;
Shin HWANG
;
Chul Soo AHN
;
Ki Hun KIM
;
Deok Bog MOON
;
Tae Yong HA
;
Gi Won SONG
;
Dong Hwan JUNG
;
Young In YOON
;
Hui Dong CHO
;
Jae Hyun KWON
;
Yong Kyu CHUNG
;
Sang Hyun KANG
;
Jin Uk CHOI
;
I Ji JUNG
;
Sung Gyu LEE
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular Carcinoma; De Novo Malignancy; Recurrence; Living Donor Liver Transplantation; Surveillance
- From:Journal of Korean Medical Science 2020;35(11):69-
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Hepatocellular carcinoma (HCC) recurrence and development of de novo malignancy (DNM) after liver transplantation (LT) are the major causes of late recipient death.METHODS: We analyzed the incidence of extrahepatic DNM following living donor LT according to the status of pretransplant hepatic malignancy. We selected 2,076 adult patients who underwent primary LDLT during 7 years from January 2010 to December 2016.RESULTS: The pretransplant hepatic malignancy group (n = 1,012) showed 45 cases (4.4%) of the following extrahepatic DNMs: posttransplant lymphoproliferative disease (PTLD) in 10; lung cancer in 10; stomach cancer in 6; colorectal cancer in 5; urinary bladder cancer in 3; and other cancers in 11. The pretransplant no hepatic malignancy group (n = 1,064) showed 25 cases (2.3%) of the following extrahepatic DNMs: colorectal cancer in 3; stomach cancer in 3; leukemia in 3; lung cancer in 3; PTLD in 2; prostate cancer in 2; and other cancers in 9. Incidences of extrahepatic DNM in the pretransplant hepatic malignancy and no hepatic malignancy groups were as follows: 1.1% and 0.5% at 1 year, 3.2% and 2.0% at 3 years, 4.6% and 2.5% at 5 years, and 5.4% and 2.8% at 8 years, respectively (P = 0.006). Their overall patient survival rates were as follows: 97.3% and 97.2% at 1 year, 91.6% and 95.9% at 3 years, 89.8% and 95.4% at 5 years, and 89.2% and 95.4% at 8 years, respectively (P < 0.001). Pretransplant hepatic malignancy was the only significant risk factor for posttransplant extrahepatic DNM.CONCLUSION: Our results suggest that patients who had pretransplant hepatic malignancy be followed up more strictly because they have a potential risk of primary hepatic malignancy recurrence as well as a higher risk of extrahepatic DNM than patients without pretransplant hepatic malignancy.
