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Long-term follow-up of lung and heart transplant recipients with pre-transplant malignancies

Sigurdardottir, Vilborg; Bjortuft, Oystein; Eiskjaer, Hans; Ekmehag, Björn LU ; Gude, Einar; Gustafsson, Finn; Hagerman, Inger; Halme, Maija; Lommi, Jyri and Mared, Lena LU , et al. (2012) In The Journal of Heart and Lung Transplantation 31(12). p.1276-1280
Abstract
BACKGROUND: Concern regarding recurrence of pre-transplant (Tx) malignancy has disqualified patients from Tx. Because this has been poorly studied in lung and heart Tx recipients our aim was to investigate the influence of pre-Tx malignancy on post-Tx recurrence and long-term survival, focusing on pre-operative cancer-free intervals. METHODS: From our lung and heart Tx programs (1983 to 2011) we retrospectively identified 111 (lung, 37; heart, 74) of 3,830 recipients with 113 pre-Tx malignancies. The patients were divided into 3 groups by pre-Tx cancer-free interval: Group I, <12 months (n = 24); Group II, >= 12 to <60 months (n = 18); and Group III, >= 60 months (n = 71). RESULTS: Mean age at pre-Tx malignancy was 35 +/- 18... (More)
BACKGROUND: Concern regarding recurrence of pre-transplant (Tx) malignancy has disqualified patients from Tx. Because this has been poorly studied in lung and heart Tx recipients our aim was to investigate the influence of pre-Tx malignancy on post-Tx recurrence and long-term survival, focusing on pre-operative cancer-free intervals. METHODS: From our lung and heart Tx programs (1983 to 2011) we retrospectively identified 111 (lung, 37; heart, 74) of 3,830 recipients with 113 pre-Tx malignancies. The patients were divided into 3 groups by pre-Tx cancer-free interval: Group I, <12 months (n = 24); Group II, >= 12 to <60 months (n = 18); and Group III, >= 60 months (n = 71). RESULTS: Mean age at pre-Tx malignancy was 35 +/- 18 years. Mean post-Tx follow-up time was 70 +/- 63 months (range, 0-278 months), and malignancy recurrence was 63% in Group I, 26% in Group II, and 6% in Group III. Kaplan-Meier analysis of freedom from post-Tx recurrence revealed the following differences among the groups: Group I vs 11, p = 0.08; II vs III, p = 0.002; and I vs III, p < 0.001. Overall survival (51 deaths) was significantly poorer in Group I than in Groups II and III (p = 0.044). Survival between Groups II and III did not differ significantly (p = 0.93). CONCLUSIONS: Cancer-free survival of >= 5 years pre-Tx is associated with the lowest recurrence. However, recurrence is related to the time the patients were cancer-free, as seen in Groups I and II. J Heart Lung Transplant 2012; 31: 1276-80 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved. (Less)
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publication status
published
subject
keywords
lung transplantation, heart transplantation, pre-transplant malignancy, recurrence, survival
in
The Journal of Heart and Lung Transplantation
volume
31
issue
12
pages
1276 - 1280
publisher
Elsevier
external identifiers
  • wos:000312414100006
  • scopus:84870531600
ISSN
1557-3117
DOI
10.1016/j.healun.2012.09.007
language
English
LU publication?
yes
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0e092bad-0b37-4e41-91c5-45867388fcc0 (old id 3366235)
date added to LUP
2013-02-01 06:56:24
date last changed
2017-07-30 03:13:31
@article{0e092bad-0b37-4e41-91c5-45867388fcc0,
  abstract     = {BACKGROUND: Concern regarding recurrence of pre-transplant (Tx) malignancy has disqualified patients from Tx. Because this has been poorly studied in lung and heart Tx recipients our aim was to investigate the influence of pre-Tx malignancy on post-Tx recurrence and long-term survival, focusing on pre-operative cancer-free intervals. METHODS: From our lung and heart Tx programs (1983 to 2011) we retrospectively identified 111 (lung, 37; heart, 74) of 3,830 recipients with 113 pre-Tx malignancies. The patients were divided into 3 groups by pre-Tx cancer-free interval: Group I, &lt;12 months (n = 24); Group II, &gt;= 12 to &lt;60 months (n = 18); and Group III, &gt;= 60 months (n = 71). RESULTS: Mean age at pre-Tx malignancy was 35 +/- 18 years. Mean post-Tx follow-up time was 70 +/- 63 months (range, 0-278 months), and malignancy recurrence was 63% in Group I, 26% in Group II, and 6% in Group III. Kaplan-Meier analysis of freedom from post-Tx recurrence revealed the following differences among the groups: Group I vs 11, p = 0.08; II vs III, p = 0.002; and I vs III, p &lt; 0.001. Overall survival (51 deaths) was significantly poorer in Group I than in Groups II and III (p = 0.044). Survival between Groups II and III did not differ significantly (p = 0.93). CONCLUSIONS: Cancer-free survival of &gt;= 5 years pre-Tx is associated with the lowest recurrence. However, recurrence is related to the time the patients were cancer-free, as seen in Groups I and II. J Heart Lung Transplant 2012; 31: 1276-80 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved.},
  author       = {Sigurdardottir, Vilborg and Bjortuft, Oystein and Eiskjaer, Hans and Ekmehag, Björn and Gude, Einar and Gustafsson, Finn and Hagerman, Inger and Halme, Maija and Lommi, Jyri and Mared, Lena and Riise, Gerdt C. and Simonsen, Svein},
  issn         = {1557-3117},
  keyword      = {lung transplantation,heart transplantation,pre-transplant malignancy,recurrence,survival},
  language     = {eng},
  number       = {12},
  pages        = {1276--1280},
  publisher    = {Elsevier},
  series       = {The Journal of Heart and Lung Transplantation},
  title        = {Long-term follow-up of lung and heart transplant recipients with pre-transplant malignancies},
  url          = {http://dx.doi.org/10.1016/j.healun.2012.09.007},
  volume       = {31},
  year         = {2012},
}