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Incidence and outcome of colorectal cancer in liver transplant recipients: A national, multicentre analysis on 8115 patients
Author(s) -
Rompianesi Gianluca,
Ravikumar Reena,
Jose Sophie,
Allison Michael,
Athale Anuja,
Creamer Felicity,
Gunson Bridget,
Manas Derek,
Monaco Andrea,
Mirza Darius,
Owen Nicola,
Roberts Keith,
Sen Gourab,
Srinivasan Parthi,
Wigmore Stephen,
Fusai Giuseppe,
Fernando Bimbi,
Burroughs Andrew,
Tsochatzis Emmanuel
Publication year - 2019
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13947
Subject(s) - medicine , primary sclerosing cholangitis , colorectal cancer , ulcerative colitis , liver transplantation , population , gastroenterology , incidence (geometry) , cancer , transplantation , disease , physics , environmental health , optics
Background & Aims De novo malignancies after liver transplantation represent one of the leading causes of death in the long‐term. It remains unclear whether liver transplant recipients have an increased risk of colorectal cancer and whether this negatively impacts on survival, particularly in those patients affected by primary sclerosing cholangitis and ulcerative colitis. Methods In this national multicentre cohort retrospective study, the incidence of colorectal cancer in 8115 evaluable adult patients undergoing a liver transplantation between 1 January 1990 and 31 December 2010 was compared to the incidence in the general population through standardised incidence ratios. Results Fifty‐two (0.6%) cases of colorectal cancer were identified at a median of 5.6 years postliver transplantation, predominantly grade 2 (76.9%) and stage T3 (50%) at diagnosis. The incidence rate of colorectal cancer in the whole liver transplant population was similar to the general UK population ( SIR : 0.92), but significantly higher ( SIR : 7.0) in the group of patients affected by primary sclerosing cholangitis/ulcerative colitis. One‐, five‐ and ten‐year survival rates from colorectal cancer diagnosis were 71%, 48% and 31%, respectively, and the majority of colorectal cancer patients died of cancer‐specific causes. Conclusions Liver transplantation alone is not associated with an increased risk of colorectal cancer development. The primary sclerosing cholangitis/ulcerative colitis liver transplant population showed a significantly higher risk of colorectal cancer development than the general population, with a high proportion of advanced stage at diagnosis and a reduced patient survival.