Clinical analysis of de novo neoplasms in patients after liver transplantation

Objective To discuss the clinical characteristics, prognosis of de novo neoplasms in patients after liver transplantation (LT). Methods Clinical data of 12 patients with de novo neoplasms (all were males, age range:12-64 years old, median age: 47 years old) of 555 patients who received follow-up after LT from May 2000 to December 2010 in Peking University People′s Hospital were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. The patients were followed up regularly after LT at the outpatient department. The clinical characteristics, prognosis of de novo neoplasms after LT were observed according to the follow-up results. Results The incidence of de novo neoplasms after LT in our hospital was 2.2% (12/555), including 6 cases of digestive system carcinoma (2 cases of hepatocellular carcinoma, 1 case of gastric adenocarcinoma, 2 cases of sigmoid colon adenocarcinoma, 1 case of rectal adenocarcinoma), 2 cases of respiratory system carcinoma (1 case of pulmonary blastoma, 1 case of lung squamous cell carcinoma), 2 cases of urinary system carcinoma (1 case of renal clear cell carcinoma, 1 case of bladder transitional cell carcinoma), 2 cases of hematologic system malignancy (1 case of acute myelocytic leukemia, 1 case of Burkitt lymphoma). The median length from LT operation to the diagnosis of neoplasms of the 12 patients in this study was 27(6-108)months. There was no specific clinical manifestation in patients with de novo neoplasms after LT. Most of the patients were in the middle or advanced stage of cancer. Mycophenolate mofetil and prednisone were stopped after the patients were diagnosed with neoplasms. The patients received corresponding treatments according to their conditions, including surgical resection, chemotherapy, targeted therapy and so on, but poor curative effects were observed. Of the 12 cases, 5 cases died with a mortality of 42%(5/12). Conclusions The de novo neoplasms in patients after LT are mainly carcinomas of digestive system, respiratory system, urinary system and hematologic system. There is no typical clinical manifestation and the prognosis is poor. Key words: Liver transplantation; Follow-up studies; Neoplasm; Diagnosis; Prognosis