TY - JOUR
T1 - Long-term follow-up of lung and heart transplant recipients with pre-transplant malignancies
AU - Sigurdardottir, Vilborg
AU - Bjortuft, Oystein
AU - Eiskjaer, Hans
AU - Ekmehag, Björn
AU - Gude, Einar
AU - Gustafsson, Finn
AU - Hagerman, Inger
AU - Halme, Maija
AU - Lommi, Jyri
AU - Mared, Lena
AU - Riise, Gerdt C.
AU - Simonsen, Svein
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
KW - lung transplantation
KW - heart transplantation
KW - pre-transplant malignancy
KW - recurrence
KW - survival
U2 - 10.1016/j.healun.2012.09.007
DO - 10.1016/j.healun.2012.09.007
M3 - Article
SN - 1557-3117
VL - 31
SP - 1276
EP - 1280
JO - The Journal of Heart and Lung Transplantation
JF - The Journal of Heart and Lung Transplantation
IS - 12
ER -
