{"title":"活体肝移植后新发恶性肿瘤的时间变化：使用标准化发病率年度比较法对 1781 名受者进行队列研究。","authors":"Tetsuya Tajima, Koichiro Hata, Kosuke Tanaka, Naomi Iyama, Jiro Kusakabe, Shoichi Kageyama, Eri Ogawa, Tatsuya Okamoto, Hironori Haga, Shinji Uemoto, Etsuro Hatano","doi":"10.1002/jhbp.12002","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>De novo malignancies (DNMs) are a major adverse event after solid organ transplantation; however, their characteristics and recent trends after living-donor liver transplantation (LDLT) remain unclear.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We retrospectively reviewed 1781 primary LDLT recipients (1990–2020) and annually calculated standardized incidence ratios (SIRs) of DNMs compared to the age-adjusted Japanese general population.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>After 21 845 person-years follow-up, 153 DNM lesions (8.6%) were identified in 131 patients (7.4%). The incidence was 0.007 person-years. DNMs included 81 post-transplant lymphoproliferative disorders (PTLDs), 14 colorectal, 12 lung, and 12 gastric cancers, and so on. Comorbid DNMs significantly worsened recipient survival than those without (<i>p</i> < .001). The 5- and 10-year recipient survival after DNM diagnosis were 65% and 58%, respectively. Notably, SIR<sub>1993–1995</sub>: 8.12 (95% CI: 3.71–15.4, <i>p</i> < .001) and SIR<sub>1996–1998</sub>: 3.11 (1.34–6.12, <i>p</i> = .01) were significantly high, but had decreased time-dependently to SIR<sub>2005–2007</sub>: 1.31 (0.68–2.29, <i>p</i> = .42) and SIR<sub>2008–2010</sub>: 1.34 (0.75–2.20, <i>p</i> = .33), indicating no longer significant difference in DNMs development. Currently, however, SIR<sub>2014–2016</sub>: 2.27 (1.54–3.22, <i>p</i> < .001) and SIR<sub>2017–2019</sub>: 2.07 (1.40–2.96, <i>p</i> < .001) have become significantly higher again, reflecting recent aging of recipients (>50 years) and resultant increases in non-PTLD DNMs. Furthermore, characteristically in LDLT, the fewer the donor-recipient HLA-mismatches, the less the post-transplant DNMs development.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>DNM development after LDLT was significantly higher than in the general population due to higher PTLD incidence (1993-1998), but once became equivalent (2005-2013), then significantly increased again (2014-2019) due to recent recipient aging and resultant increase in solid cancers.</p>\n </section>\n </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12002","citationCount":"0","resultStr":"{\"title\":\"Chronological alterations in de novo malignancies after living-donor liver transplantation: A cohort study of 1781 recipients using annual comparisons of standardized incidence ratios\",\"authors\":\"Tetsuya Tajima, Koichiro Hata, Kosuke Tanaka, Naomi Iyama, Jiro Kusakabe, Shoichi Kageyama, Eri Ogawa, Tatsuya Okamoto, Hironori Haga, Shinji Uemoto, Etsuro Hatano\",\"doi\":\"10.1002/jhbp.12002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>De novo malignancies (DNMs) are a major adverse event after solid organ transplantation; however, their characteristics and recent trends after living-donor liver transplantation (LDLT) remain unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We retrospectively reviewed 1781 primary LDLT recipients (1990–2020) and annually calculated standardized incidence ratios (SIRs) of DNMs compared to the age-adjusted Japanese general population.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>After 21 845 person-years follow-up, 153 DNM lesions (8.6%) were identified in 131 patients (7.4%). The incidence was 0.007 person-years. DNMs included 81 post-transplant lymphoproliferative disorders (PTLDs), 14 colorectal, 12 lung, and 12 gastric cancers, and so on. Comorbid DNMs significantly worsened recipient survival than those without (<i>p</i> < .001). The 5- and 10-year recipient survival after DNM diagnosis were 65% and 58%, respectively. Notably, SIR<sub>1993–1995</sub>: 8.12 (95% CI: 3.71–15.4, <i>p</i> < .001) and SIR<sub>1996–1998</sub>: 3.11 (1.34–6.12, <i>p</i> = .01) were significantly high, but had decreased time-dependently to SIR<sub>2005–2007</sub>: 1.31 (0.68–2.29, <i>p</i> = .42) and SIR<sub>2008–2010</sub>: 1.34 (0.75–2.20, <i>p</i> = .33), indicating no longer significant difference in DNMs development. Currently, however, SIR<sub>2014–2016</sub>: 2.27 (1.54–3.22, <i>p</i> < .001) and SIR<sub>2017–2019</sub>: 2.07 (1.40–2.96, <i>p</i> < .001) have become significantly higher again, reflecting recent aging of recipients (>50 years) and resultant increases in non-PTLD DNMs. Furthermore, characteristically in LDLT, the fewer the donor-recipient HLA-mismatches, the less the post-transplant DNMs development.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>DNM development after LDLT was significantly higher than in the general population due to higher PTLD incidence (1993-1998), but once became equivalent (2005-2013), then significantly increased again (2014-2019) due to recent recipient aging and resultant increase in solid cancers.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-06-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12002\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12002\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhbp.12002","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Chronological alterations in de novo malignancies after living-donor liver transplantation: A cohort study of 1781 recipients using annual comparisons of standardized incidence ratios
Background
De novo malignancies (DNMs) are a major adverse event after solid organ transplantation; however, their characteristics and recent trends after living-donor liver transplantation (LDLT) remain unclear.
Methods
We retrospectively reviewed 1781 primary LDLT recipients (1990–2020) and annually calculated standardized incidence ratios (SIRs) of DNMs compared to the age-adjusted Japanese general population.
Results
After 21 845 person-years follow-up, 153 DNM lesions (8.6%) were identified in 131 patients (7.4%). The incidence was 0.007 person-years. DNMs included 81 post-transplant lymphoproliferative disorders (PTLDs), 14 colorectal, 12 lung, and 12 gastric cancers, and so on. Comorbid DNMs significantly worsened recipient survival than those without (p < .001). The 5- and 10-year recipient survival after DNM diagnosis were 65% and 58%, respectively. Notably, SIR1993–1995: 8.12 (95% CI: 3.71–15.4, p < .001) and SIR1996–1998: 3.11 (1.34–6.12, p = .01) were significantly high, but had decreased time-dependently to SIR2005–2007: 1.31 (0.68–2.29, p = .42) and SIR2008–2010: 1.34 (0.75–2.20, p = .33), indicating no longer significant difference in DNMs development. Currently, however, SIR2014–2016: 2.27 (1.54–3.22, p < .001) and SIR2017–2019: 2.07 (1.40–2.96, p < .001) have become significantly higher again, reflecting recent aging of recipients (>50 years) and resultant increases in non-PTLD DNMs. Furthermore, characteristically in LDLT, the fewer the donor-recipient HLA-mismatches, the less the post-transplant DNMs development.
Conclusion
DNM development after LDLT was significantly higher than in the general population due to higher PTLD incidence (1993-1998), but once became equivalent (2005-2013), then significantly increased again (2014-2019) due to recent recipient aging and resultant increase in solid cancers.
期刊介绍：
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
