High frequency of bronchogenic carcinoma after single-lung transplantation
High frequency of bronchogenic carcinoma after single-lung transplantation
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DOI：
10.1016/j.healun.2006.09.009
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发表时间：
2006-11-01
影响因子：
8.9
通讯作者：
Palmer, Scott M.
中科院分区：
文献类型：
--
作者：
Dickson, Robert P.;Davis, R. Duane;Palmer, Scott M.
背景：肺移植是一种治疗与烟草使用有关的晚期肺部疾病患者的常见治疗。关于肺移植后原发性肺癌的长期发病率或危险因素知之甚少。为了确定肺移植后原发支气管恶性恶性肿瘤的频率，临床特征和危险因素，我们设计了一项匹配的队列研究，对单侧和双侧肺移植受者进行了扩展随访。生存：移植后90天，并评估了原发性肺癌的发展。通过天然疾病，将1001个连续的单肺移植（SLTX）接收者与131个连续的双侧肺移植（BLTX）受体匹配。使用单变量和多变量比例危害模型得出了肺癌发展的危险因素。反应：在移植后，有6.9％的接受者与BLTX接受者的0％（P = 0.002）相比，有6.9％的接受者（P = 0.002）出现了原发性肺癌（P = 0.002）。 52个月。从组织学上讲，非小细胞癌症存在于本地肺中，尽管治疗了97％（9个）患者的死亡。与BLTX相比与具有可比的本土疾病，年龄和烟草病史的患者相比，移植与BLTX相比，与BLTX相比，移植率显着升高了产生原发性后移植后肺癌的风险。
Background: Lung transplantation is a commonly employed therapy in the treatment of patients with advanced lung diseases related to tobacco use. Little is known about the long-term incidence or risk factors for primary lung cancer after lung transplantation. To determine the frequency, clinical features and risk factors for primary bronchogenic malignancy after lung transplantation, we designed a matched cohort study of single and bilateral lung transplant recipients with extended follow-up.Methods: We retrospectively reviewed the records of 262 lung transplant recipients who survived :90 days post-transplant and assessed for the development of primary lung cancer. One hundred thirty-one consecutive single-lung transplant (SLTx) recipients were matched to 131 consecutive bilateral lung transplant (BLTx) recipients by native disease. Risk factors for lung cancer development were derived using univariate and multivariate proportional hazards models.Results: Of the SLTx recipients, 6.9% developed primary lung cancer after transplantation as compared with 0% of the BLTx recipients (p = 0.002), after a mean of 52 months. Histologically, non-small-cell cancers were present in the native lung, which led to death in 67% (6 of 9) of the patients despite treatment. Significant risk factors for the development of primary lung cancer were increasing age (p = 0.004), > 60-pack-year smoking history (p = 0.03), and SLTx as compared with BLTx (p < 0.001).Conclusions: Single-lung transplant confers a significantly elevated risk of developing primary post-transplant lung cancer as compared with BLTx in patients with comparable native disease, age and tobacco history.