Clinical analysis of de novo neoplasms in patients after liver transplantation

doi:10.3877/cma.j.issn.2095-3232.2013.06.006

Abstract

Abstract:

Objective

To discuss the clinical characteristics, prognosis of de novo neoplasms in patients after liver transplantation (LT).

Methods

Clinical data of 12 patients with de novo neoplasms (all were males, age range:12-64 years old, median age: 47 years old) of 555 patients who received follow-up after LT from May 2000 to December 2010 in Peking University People′s Hospital were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. The patients were followed up regularly after LT at the outpatient department. The clinical characteristics, prognosis of de novo neoplasms after LT were observed according to the follow-up results.

Results

The incidence of de novo neoplasms after LT in our hospital was 2.2% (12/555), including 6 cases of digestive system carcinoma (2 cases of hepatocellular carcinoma, 1 case of gastric adenocarcinoma, 2 cases of sigmoid colon adenocarcinoma, 1 case of rectal adenocarcinoma), 2 cases of respiratory system carcinoma (1 case of pulmonary blastoma, 1 case of lung squamous cell carcinoma), 2 cases of urinary system carcinoma (1 case of renal clear cell carcinoma, 1 case of bladder transitional cell carcinoma), 2 cases of hematologic system malignancy (1 case of acute myelocytic leukemia, 1 case of Burkitt lymphoma). The median length from LT operation to the diagnosis of neoplasms of the 12 patients in this study was 27(6-108)months. There was no specific clinical manifestation in patients with de novo neoplasms after LT. Most of the patients were in the middle or advanced stage of cancer. Mycophenolate mofetil and prednisone were stopped after the patients were diagnosed with neoplasms. The patients received corresponding treatments according to their conditions, including surgical resection, chemotherapy, targeted therapy and so on, but poor curative effects were observed. Of the 12 cases, 5 cases died with a mortality of 42%(5/12).

Conclusions

The de novo neoplasms in patients after LT are mainly carcinomas of digestive system, respiratory system, urinary system and hematologic system. There is no typical clinical manifestation and the prognosis is poor.

Key words: Liver transplantation, Follow-up studies, Neoplasm, Diagnosis, Prognosis

Xin-yu LI, Guang-ming LI, Lei HUANG, Ji-ye ZHU, Xi-sheng LENG. Clinical analysis of de novo neoplasms in patients after liver transplantation[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2013, 02(06): 371-374.

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References 17

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例序	性别	肝移植时的年龄（岁）	原发病	肝移植术后确诊时间（月）	新发恶性肿瘤类型	确诊时FK506血药浓度(ng/ml)	治疗后FK506血药浓度(ng/ml)	治疗措施	预后
1	男	12	乙肝后肝硬化	13	伯基特淋巴瘤	7.9	4.2	保守治疗	死亡
2	男	45	乙肝后肝硬化	17	急性髓细胞白血病	5.8	3.1	全身化疗	死亡
3	男	56	乙肝后肝硬化	6	肺母细胞瘤	8.1	4.9	肺叶切除+术后放化疗	死亡
4	男	48	肝癌，乙肝后肝硬化	72	肝癌	4.2	2.6	TACE	死亡
5	男	49	慢性重型乙肝	14	肝癌	5.2	4.5	肝癌切除+TACE	死亡
6	男	50	单纯丙肝后肝硬化	10	膀胱移行细胞癌	8.6	5.2	经尿道膀胱镜下肿瘤电切术+膀胱灌注化疗	存活
7	男	55	乙肝后肝硬化	108	胃中分化腺癌	4.6	3.0	姑息性胃癌切除术	存活
8	男	58	肝癌，乙肝后肝硬化	76	乙状结肠中分化腺癌	4.8	4.0	乙状结肠癌根治性切除术	存活
9	男	43	乙肝后肝硬化	18	直肠中分化腺癌	5.3	4.1	直肠癌根治性切除术	存活
10	男	64	肝癌，乙肝后肝硬化	80	肾透明细胞癌	4.5	3.9	腹腔镜下肾癌根治性切除术	存活
11	男	54	乙肝后肝硬化	36	肺鳞癌	5.2	4.0	索拉菲尼靶向治疗	存活
12	男	48	乙肝后肝硬化	42	乙状结肠中低分化腺癌	4.9	4.2	乙状结肠癌根治性切除术	存活

例序	性别	肝移植时的年龄（岁）	原发病	肝移植术后确诊时间（月）	新发恶性肿瘤类型	确诊时FK506血药浓度(ng/ml)	治疗后FK506血药浓度(ng/ml)	治疗措施	预后
1	男	12	乙肝后肝硬化	13	伯基特淋巴瘤	7.9	4.2	保守治疗	死亡
2	男	45	乙肝后肝硬化	17	急性髓细胞白血病	5.8	3.1	全身化疗	死亡
3	男	56	乙肝后肝硬化	6	肺母细胞瘤	8.1	4.9	肺叶切除+术后放化疗	死亡
4	男	48	肝癌，乙肝后肝硬化	72	肝癌	4.2	2.6	TACE	死亡
5	男	49	慢性重型乙肝	14	肝癌	5.2	4.5	肝癌切除+TACE	死亡
6	男	50	单纯丙肝后肝硬化	10	膀胱移行细胞癌	8.6	5.2	经尿道膀胱镜下肿瘤电切术+膀胱灌注化疗	存活
7	男	55	乙肝后肝硬化	108	胃中分化腺癌	4.6	3.0	姑息性胃癌切除术	存活
8	男	58	肝癌，乙肝后肝硬化	76	乙状结肠中分化腺癌	4.8	4.0	乙状结肠癌根治性切除术	存活
9	男	43	乙肝后肝硬化	18	直肠中分化腺癌	5.3	4.1	直肠癌根治性切除术	存活
10	男	64	肝癌，乙肝后肝硬化	80	肾透明细胞癌	4.5	3.9	腹腔镜下肾癌根治性切除术	存活
11	男	54	乙肝后肝硬化	36	肺鳞癌	5.2	4.0	索拉菲尼靶向治疗	存活
12	男	48	乙肝后肝硬化	42	乙状结肠中低分化腺癌	4.9	4.2	乙状结肠癌根治性切除术	存活

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