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Characteristics, outcomes, and predictors of de novo malignancy after heart transplantation

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Author(s)
Jong-Chan YounDarae KimIn-Cheol KimHye Sun LeeJin-Oh ChoiEun-Seok JeonKeith NishiharaEvan P KransdorfDavid H ChangMichelle M KittlesonJignesh K PatelDanny RamzyFardad EsmailianJon A Kobashigawa
Keimyung Author(s)
Kim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Front Cardiovasc Med
Issued Date
2022
Volume
9
Keyword
de novo malignancies after heart transplantationheart transplantoutcomepost-transplant malignancyprognosis
Abstract
Background:
Post-transplant malignancy (PTM) causes long-term morbidity and mortality in heart transplant (HTx) recipients. However, the detailed characteristics or predictors of PTM are not well-known. We evaluated the incidence, characteristics, long-term outcomes, and predictors of de novo PTM using a single center large-volume database.

Methods:
We retrospectively analyzed the types and characteristics of de novo PTM in 989 patients who underwent HTx. Univariate and multivariate logistic regression analyses were used for the PTM prediction model.

Results:
Two hundred and six patients (20.8%) had de novo PTMs (241 cancers) during a median follow-up of 11.5 years. PTM patients were older than non-PTM patients, received immunosuppressive therapy for a longer period, and were more likely to be male and white. Skin cancers were the most frequent types of malignancy (60.6%) followed by prostate (9.5%), lung (7.1%), and breast (4.1%) cancers. Although most cancers (88.8%) were surgically resected at initial presentation, about half (47.3%) recurred or progressed. Patients with skin cancer and non-skin cancer had significantly lower overall survival (P < 0.001) than patients without cancer. Older age (P < 0.001), white race (P = 0.001), and longer time receiving immunosuppressive therapy (P < 0.001) were independent predictors for PTM.

Conclusion:
Older age, white race, and longer administration of immunosuppressive therapies were independent risk factors for PTM, which was associated with increased mortality. Further research is necessary for the prevention and early detection of PTM in HTx recipients.
Keimyung Author(s)(Kor)
김인철
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2297-055X
Source
https://www.frontiersin.org/articles/10.3389/fcvm.2022.939275/fullhttps://www.frontiersin.org/articles/10.3389/fcvm.2022.939275/full
DOI
10.3389/fcvm.2022.939275
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44530
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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