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Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation

Long-term survival after heart transplantation (HTX) is impacted by adverse effects of immunosuppressive pharmacotherapy, and post-transplant lung cancer is a common occurrence. This study aimed to examine the risk factors, treatment, and prognosis of patients with post-transplant lung cancer. We in...

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Autores principales: Heil, Karsten M., Helmschrott, Matthias, Darche, Fabrice F., Bruckner, Tom, Ehlermann, Philipp, Kreusser, Michael M., Doesch, Andreas O., Sommer, Wiebke, Warnecke, Gregor, Frey, Norbert, Rivinius, Rasmus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707242/
https://www.ncbi.nlm.nih.gov/pubmed/34947875
http://dx.doi.org/10.3390/life11121344
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author Heil, Karsten M.
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Ehlermann, Philipp
Kreusser, Michael M.
Doesch, Andreas O.
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
author_facet Heil, Karsten M.
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Ehlermann, Philipp
Kreusser, Michael M.
Doesch, Andreas O.
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
author_sort Heil, Karsten M.
collection PubMed
description Long-term survival after heart transplantation (HTX) is impacted by adverse effects of immunosuppressive pharmacotherapy, and post-transplant lung cancer is a common occurrence. This study aimed to examine the risk factors, treatment, and prognosis of patients with post-transplant lung cancer. We included 625 adult patients who received HTX at Heidelberg Heart Center between 1989 and 2018. Patients were stratified by diagnosis and staging of lung cancer after HTX. Analysis comprised donor and recipient characteristics, medications including immunosuppressive drugs, and survival after diagnosis of lung cancer. A total of 41 patients (6.6%) were diagnosed with lung cancer after HTX, 13 patients received curative care and 28 patients had palliative care. Mean time from HTX until diagnosis of lung cancer was 8.6 ± 4.0 years and 1.8 ± 2.7 years from diagnosis of lung cancer until last follow-up. Twenty-four patients (58.5%) were switched to an mTOR-inhibitor after diagnosis of lung cancer. Multivariate analysis showed recipient age (HR: 1.05; CI: 1.01–1.10; p = 0.02), COPD (HR: 3.72; CI: 1.88–7.37; p < 0.01), and history of smoking (HR: 20.39; CI: 2.73–152.13; p < 0.01) as risk factors for post-transplant lung cancer. Patients in stages I and II had a significantly better 1-year (100.0% versus 3.6%), 2-year (69.2% versus 0.0%), and 5-year survival (53.8% versus 0.0%) than patients in stages III and IV (p < 0.01). Given the poor prognosis of late-stage post-transplant lung cancer, routine reassessment of current smoking status, providing smoking cessation support, and intensified lung cancer screening in high-risk HTX recipients are advisable.
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spelling pubmed-87072422021-12-25 Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation Heil, Karsten M. Helmschrott, Matthias Darche, Fabrice F. Bruckner, Tom Ehlermann, Philipp Kreusser, Michael M. Doesch, Andreas O. Sommer, Wiebke Warnecke, Gregor Frey, Norbert Rivinius, Rasmus Life (Basel) Article Long-term survival after heart transplantation (HTX) is impacted by adverse effects of immunosuppressive pharmacotherapy, and post-transplant lung cancer is a common occurrence. This study aimed to examine the risk factors, treatment, and prognosis of patients with post-transplant lung cancer. We included 625 adult patients who received HTX at Heidelberg Heart Center between 1989 and 2018. Patients were stratified by diagnosis and staging of lung cancer after HTX. Analysis comprised donor and recipient characteristics, medications including immunosuppressive drugs, and survival after diagnosis of lung cancer. A total of 41 patients (6.6%) were diagnosed with lung cancer after HTX, 13 patients received curative care and 28 patients had palliative care. Mean time from HTX until diagnosis of lung cancer was 8.6 ± 4.0 years and 1.8 ± 2.7 years from diagnosis of lung cancer until last follow-up. Twenty-four patients (58.5%) were switched to an mTOR-inhibitor after diagnosis of lung cancer. Multivariate analysis showed recipient age (HR: 1.05; CI: 1.01–1.10; p = 0.02), COPD (HR: 3.72; CI: 1.88–7.37; p < 0.01), and history of smoking (HR: 20.39; CI: 2.73–152.13; p < 0.01) as risk factors for post-transplant lung cancer. Patients in stages I and II had a significantly better 1-year (100.0% versus 3.6%), 2-year (69.2% versus 0.0%), and 5-year survival (53.8% versus 0.0%) than patients in stages III and IV (p < 0.01). Given the poor prognosis of late-stage post-transplant lung cancer, routine reassessment of current smoking status, providing smoking cessation support, and intensified lung cancer screening in high-risk HTX recipients are advisable. MDPI 2021-12-04 /pmc/articles/PMC8707242/ /pubmed/34947875 http://dx.doi.org/10.3390/life11121344 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Heil, Karsten M.
Helmschrott, Matthias
Darche, Fabrice F.
Bruckner, Tom
Ehlermann, Philipp
Kreusser, Michael M.
Doesch, Andreas O.
Sommer, Wiebke
Warnecke, Gregor
Frey, Norbert
Rivinius, Rasmus
Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title_full Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title_fullStr Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title_full_unstemmed Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title_short Risk Factors, Treatment and Prognosis of Patients with Lung Cancer after Heart Transplantation
title_sort risk factors, treatment and prognosis of patients with lung cancer after heart transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707242/
https://www.ncbi.nlm.nih.gov/pubmed/34947875
http://dx.doi.org/10.3390/life11121344
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