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De novo solid malignancies after cardiac transplantation
D J Goldstein1, D L Williams, M C Oz
1Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA.
The Annals of Thoracic Surgery
|December 1, 1995
Summary
Solid tumors are a growing concern after heart transplantation. This study found they occur less often than lymphoproliferative disorders, with pulmonary and urologic cancers being most common.
Area of Science:
- Cardiology
- Oncology
- Transplantation Medicine
Background:
- Long-term survival post-cardiac transplant leads to increased detection of neoplastic complications.
- While lymphoproliferative disorders are common, the incidence and characteristics of solid tumors in heart transplant recipients are not well-defined.
Purpose of the Study:
- To determine the incidence and clinical spectrum of de novo solid tumors in heart transplant recipients.
- To analyze survival outcomes following de novo solid malignancy after cardiac transplantation.
Main Methods:
- Retrospective review of clinical charts for 712 cardiac transplant patients.
- Inclusion of telephone interviews for data collection where possible.
Main Results:
- De novo solid malignancies were identified in 3.3% of eligible patients (21/633).
- Pulmonary, urologic cancers, and Kaposi's sarcoma were the most frequent, with a mean diagnosis interval of 35 months post-transplant.
- One-year survival post-transplant was 90%, and post-cancer diagnosis was 60%.
Conclusions:
- De novo solid malignancy occurs at approximately half the rate of lymphoproliferative disorders post-transplant.
- A significant male predominance was observed, and a history of smoking necessitates thorough pre-transplant cancer screening.
- The timing of cancer diagnosis post-transplant is variable, with no identified clustering.