Abstract 197P
Background
Malignancies rank the third cause of death after solid organ transplantation. Lung cancer is reported to be 20-25-times higher in transplant patients compared to the general population with an incidence of 0.1-4.1 % in lung transplant recipients. Potential contributory factors are increasing age, smoking history and immunosuppression. Lung cancer can be transmitted from the donor to recipient, as a finding in the explanted lung or newly formed.
Methods
The aim of our retrospective study was to evaluate the prevalence, origin, management and outcome of lung cancer in all patients who underwent lung transplantation from 2010 to 2019 in our institution.
Results
From 343 transplanted patients in 2010-2019 lung cancer was detected in 12 (3.5 %) patients, predominantly in men 91.7 %. The median donorś age in patients with lung cancer was 50.75 ± 9.99. Unexpected neoplasm in explanted lung occurred in three patients after double lung transplantation. Three patients after single lung transplantation developed lung cancer in the native lung. One patient was an extended lung cancer donor recipient. Five lung cancers developed de novo. 91.7 % lung tumors were non-small-cell lung cancer. 50% were squamous cell carcinomas and adenocarcinomas. The median time from transplantation to cancer diagnosis was 2.12 ± 2.57 years. Four patients (33.3 %) underwent thoracotomy, one patient radiorobotic surgery and one patient was cured by chemotherapy with doxorubicin. Three patients with lung cancer in explanted lung were followed up and the rest were treated palliatively. Immunosuppression was reduced in seven patients (58.3 %). The overal median survival from transplant to date of death in recipients with lung cancer was 6.89 years. Survival rate was 83.3%, 75% and 66.7% 1, 3 and 5 years, respectively, after lung transplantation.
Conclusions
Lung cancer in lung transplant recipients remains rare. Careful examination of computed tomographic scans before transplantation may reduce the number of lung cancers in explanted lung. The screening protocol after transplantation plays a significant role in prevention of any malignancy. The optimal immunosuppresion treatment after diagnosed malignancy is still missing. Lung cancer was not associated with an overall decrease in survival time in our study.
Legal entity responsible for the study
Svorcova Monika.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.