Colorectal carcinoma after liver transplantation

Abstract

Summary: Introduction: Patients after liver transplantation (LTx) have an increased risk of developing malignancies, especially skin malignancies and lymphomas. Colorectal cancer is one of the most common malignancies, its incidence may be higher after transplantation of certain organs. In liver transplant patients, the risk of developing CRC is not clearly known. Aim and methods: The aim of this work was to evaluate the incidence of CRC in patients after liver transplantation and to enrich these data with our own experience from our transplant center. Results: In the literature, the documented incidence of colorectal cancer ranges from comparable to twice as high, compared to the general population. Most studies evaluate incidence of different tumors after transplantatin of various organs irrespective of the indication for transplantation. An unequivocally proven risk factor is the presence of primary sclerosing cholangitis by ulcerative colitis, which is, however, a precancer in itself. Studies in which non-PSC and UC liver transplant recipients were evaluated separately mostly did not show an increased risk of CRC. Conclusion: According to most studies, the incidence of colorectal cancer in all liver transplant patients is slightly higher than in the general population. The risk of PSC/UC in liver transplant patients is significantly higher, which strongly supports the necessity of their regular endoscopic surveillance. In patients transplanted for other indications, the risk of developing CRC seems comparable with the general population. Posttransplant CRC is characterized by location in the right colon, diagnosis at a later stage and worse prognosis. Key words: transplantation – liver transplantion– colorectal carcinoma