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KMID : 0191120200350110069
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Journal of Korean Medical Science
2020 Volume.35 No. 11 p.69 ~ p.69
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Pretransplant Hepatic Malignancy Increases Risk of De Novo Malignancy after Liver Transplantation
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Park Gil-Chun
Hwang Shin
Ahn Chul-Soo
Kim Ki-Hun
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
Yoon Young-In
Cho Hui-Dong
Kwon Jae-Hyun
Chung Yong-Kyu
Kang Sang-Hyun
Choi Jin-Uk
Jung I-Ji
Lee Sung-Gyu
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Abstract
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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.
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KEYWORD
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Hepatocellular Carcinoma, De Novo Malignancy, Recurrence, Living Donor Liver Transplantation, Surveillance
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