肝移植术后一种或几种连续肿瘤是否影响生存？一项法国国家研究

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-02-13 DOI:10.1111/ctr.70109

Anaïs R. Briant, Rémy Morello, Olivier Sérée, Nicolas Vigneron, Sarah Wilson, Camille Besch, Pauline Houssel-Debry, Georges-Philippe Pageaux, Audrey Coilly, Jérôme Dumortier, Mario Altieri

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引用次数: 0

摘要

背景和目的肝移植术后新生肿瘤（LT）是肝移植术后并发症和死亡的主要原因，文献中未见几种继发肿瘤（SSC）的报道。本研究的目的是观察一种或多种癌症的生存是否不同，并研究一种癌症或SSC患者在LT后的生存预后因素。方法使用法国国家数据库的数据，对1993年至2012年期间接受LT的114名法国患者进行随访，直到他们死亡或直到2016年6月。采用Cox模型分析潜在的危险因素（癌症特征、免疫抑制疗法（IT）、吸烟和饮酒）。结果平均随访9.8±5.1年，1癌52例，2癌49例，3癌13例。生存时间的缩短与转移期显著且独立相关(风险比(HR) = 3.98, 95%可信区间(95% CI) = [1.45-10.93], p <；0.001)、耳鼻喉科（耳鼻喉科）和呼吸系统癌与泌尿生殖系统癌(HR = 8.28, 95% CI = [3.12-22.02], p <；0.001)和SSC （HR = 2.54, 95% CI = [1.39-4.65], p = 0.014）。结论耳鼻喉、呼吸道肿瘤患者生存期较短。癌症分期和SSC降低了中位生存期为10年。第一个癌症的早期应被视为SSC风险和生存受损的警告信号。

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Is Survival Impacted by One or Several Successive Cancers After Liver Transplantation? A French National Study

Background and Aim

De novo cancers after liver transplantation (LT) are major causes of complications and mortality after LT. No report was found in the literature on several successive cancers (SSC). The aim of this study was to see if the survival of one or more cancers was different and to study the survival prognostic factors of patients with one cancer or SSC after LT.

Methods

Using data from the French national database, 114 French patients who underwent LT between 1993 and 2012 were followed up until their death or until June 2016. The Cox model performed to analyze potential risk factors (cancer characteristics, immunosuppressive therapy (IT), smoking, and alcohol use).

Results

After an average follow-up of 9.8 ± 5.1 years, 52 patients developed 1 cancer, 49 had 2 cancers, and 13 had 3 cancers. The reduction in survival time was significantly and independently associated with the metastatic stage (hazard ratio (HR) = 3.98, 95% confidence interval (95% CI) = [1.45–10.93], p < 0.001), ENT (otolaryngology), and respiratory cancer versus genitourinary (HR = 8.28, 95% CI = [3.12–22.02], p < 0.001), and SSC (HR = 2.54, 95% CI = [1.39–4.65], p = 0.014).

Conclusion

The patients with ENT, respiratory cancers have a shorter survival. The stage of cancer and SSC reduces median survival at 10 years. The earliness of the first cancer should be taken as a warning signal of risk of SSC and impaired survival.

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.