Premium
Risk of virus and non‐virus related malignancies following immunosuppression in a cohort of liver transplant recipients. Italy, 1985–2014
Author(s) -
Taborelli Martina,
Piselli Pierluca,
Ettorre Giuseppe Maria,
Lauro Augusto,
Galatioto Laura,
Baccarani Umberto,
Rendina Maria,
Shalaby Sarah,
Petrara Raffaella,
Nudo Francesco,
Toti Luca,
Sforza Daniele,
Fantola Giovanni,
Cimaglia Claudia,
Agresta Alessandro,
Vennarecci Giovanni,
Pinna Antonio Daniele,
Gruttadauria Salvatore,
Risaliti Andrea,
Di Leo Alfredo,
Burra Patrizia,
Rossi Massimo,
Tisone Giuseppe,
Zamboni Fausto,
Serraino Diego
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31552
Subject(s) - medicine , skin cancer , population , cancer , cohort , immunosuppression , relative risk , standardized mortality ratio , gastroenterology , incidence (geometry) , sarcoma , confidence interval , pathology , physics , environmental health , optics
This cohort study assessed, in Italy, the overall pattern of risk of de novo malignancies following liver transplantation (LT). The study group included 2,832 individuals who underwent LT between 1985 and 2014 in nine centers all over Italy. Person–years (PYs) at cancer risk were computed from 30 days after LT to the date of cancer diagnosis, to the date of death or to the end of follow‐up. Excess cancer risk, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). During 18,642 PYs, 246 LT recipients developed 266 de novo malignancies, corresponding to a 1.8‐fold higher cancer risk (95% CI: 1.6–2.0). SIRs were particularly elevated for virus‐related malignancies, including Kaposi's sarcoma (SIR = 53.6, 95% CI: 30.0–88.5), non‐Hodgkin lymphomas (SIR = 7.1, 95% CI: 4.8–10.1) and cervix uteri (SIR = 5.4, 95% CI: 1.1–15.8). Among virus‐unrelated malignancies, elevated risks emerged for head and neck (SIR = 4.4, 95% CI: 3.1–6.2), esophagus (SIR = 6.7, 95% CI: 2.9–13.3) and adrenal gland (SIR = 22.9, 95% CI: 2.8–82.7). Borderline statistically significant elevated risks were found for lung cancer (SIR = 1.4, 95% CI: 1.0–2.1) and skin melanoma (SIR = 2.6, 95% CI: 1.0–5.3). A reduced risk emerged for prostate cancer (SIR = 0.1, 95% CI: 0.0–0.5). These findings underline the need of preventive interventions and early detection of malignancies, specifically tailored to LT recipients.