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Characteristics and Prognosis of Colorectal Cancer after Liver or Kidney Transplantation

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Abstract

Background

The purpose of this study was to evaluate the characteristics and prognosis of de novo CRC patients who underwent liver or kidney transplantation.

Methods

We retrospectively reviewed the medical records of 66 de novo CRC patients selected from 8,734 liver transplant (LT) or kidney transplant (KT) recipients. We analyzed characteristics and survival outcomes of de novo CRC patients and sporadic CRC patients who underwent radical surgery with stage I-III in Asan Medical Center between 2005 and 2016. Survival outcomes were analyzed via the 1:4 matching method.

Results

The standard incidence ratio (SIR) of de novo CRC in KT recipients is 1.67 in men and 2.54 in women. That in LT recipients is 3.10 in men and 2.25 in women. Compared with sporadic CRC patients, de novo CRC patients had more colon cancer than rectal cancer (p=0.041). In 9 patients (13.6%), CRC was diagnosed within one year after transplantation, 21 patients (31.8%) were diagnosed between 1–5 years, and the remaining 36 patients (54.6%) were diagnosed thereafter. There were no significant differences in recurrence-free survival and overall survival between the two groups (p=0.211 and p=0.324, respectively).

Conclusions

The risk of developing de novo CRC in transplant recipients was higher than in the general population. The survival outcome of de novo CRC was no different compared with the sporadic CRC. Therefore, regular surveillance is essential for timely diagnosis and treatment for transplantation patients. A large prospective study for an intense CRC surveillance program in transplantation patients is needed.

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References

  1. OPTN/SRTR 2017 Annual data report: introduction. Am J Transplant 19:11–18 (2019)

  2. Merchea A, Abdelsattar ZM, Taner T et al (2014) Outcomes of colorectal cancer arising in solid organ transplant recipients. J Gastrointest Surg 18:599–604

    Article  Google Scholar 

  3. Jung DH, Hwang S, Song GW et al (2016) Survival benefit of early cancer detection through regular endoscopic screening for de novo gastric and colorectal cancers in korean liver transplant recipients. Transpl Proc 48:145–151

    Article  CAS  Google Scholar 

  4. Papaconstantinou HT, Sklow B, Hanaway MJ et al (2004) Characteristics and survival patterns of solid organ transplant patients developing de novo colon and rectal cancer. Dis Colon Rectum 47:1898–1903

    Article  Google Scholar 

  5. Jeong IJ, Lee S-G, Kim YH et al (2018) Characteristics and prognosis of breast cancer after liver or kidney transplantation. Breast Cancer Res Treat 167:101–106

    Article  Google Scholar 

  6. Penn I (1993) Tumors after renal and cardiac transplantation. Hematol Oncol Clin North Am 7:431–445

    Article  CAS  Google Scholar 

  7. Silva MA, Jambulingam PS, Mirza DF (2005) Colorectal cancer after orthotopic liver transplantation. Crit Rev Oncol Hematol 56:147–153

    Article  Google Scholar 

  8. Breslow NE, Day NE (1987) Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. IARC Sci Publ:1–406

  9. Kang EA, Koh SJ, Kim JW et al (2018) Prevalence of advanced colorectal neoplasm is higher in liver transplant recipients. Turk J Gastroenterol 29:316–324

    Article  Google Scholar 

  10. Nicolaas JS, De Jonge V, Steyerberg EW et al (2010) Risk of colorectal carcinoma in post-liver transplant patients: a systematic review and meta-analysis. Am J Transplant 10:868–876

    Article  Google Scholar 

  11. Johnson EE, Leverson GE, Pirsch JD et al (2007) A 30-Year Analysis of Colorectal Adenocarcinoma in Transplant Recipients and Proposal for Altered Screening. J Gastrointest Surg 11:272

    Article  Google Scholar 

  12. Rompianesi G, Ravikumar R, Jose S et al (2019) Incidence and outcome of colorectal cancer in liver transplant recipients: a national, multicentre analysis on 8115 patients. Liver Int 39:353–360

    Article  Google Scholar 

  13. Nordin A, Åberg F, Pukkala E et al (2018) Decreasing incidence of cancer after liver transplantation—A Nordic population-based study over 3 decades. Am J Transplant 18:952–963

    Article  CAS  Google Scholar 

  14. Aigner F, Boeckle E, Albright J et al (2007) Malignancies of the colorectum and anus in solid organ recipients. Transpl Int 20:497–504

    Article  Google Scholar 

  15. Sint Nicolaas J, Tjon AS, Metselaar HJ et al (2010) Colorectal cancer in post-liver transplant recipients. Dis Colon Rectum 53:817–821

    Article  Google Scholar 

  16. Ye BD, Yang SK, Boo SJ et al (2011) Clinical characteristics of ulcerative colitis associated with primary sclerosing cholangitis in Korea. Inflamm Bowel Dis 17:1901–1906

    Article  Google Scholar 

  17. Kim JY, Ju MK, Kim MS et al (2011) Clinical characteristics and treatment outcomes of colorectal cancer in renal transplant recipients in Korea. Yonsei Med J 52:454–462

    Article  Google Scholar 

  18. Stewart T, Henderson R, Grayson H et al (1997) Reduced incidence of rectal cancer, compared to gastric and colonic cancer, in a population of 73,076 men and women chronically immunosuppressed. Clin Cancer Res 3:51

    CAS  PubMed  Google Scholar 

  19. Buell JF, Papaconstantinou HT, Skalow B et al (2005) de novo colorectal cancer: five-year survival is markedly lower in transplant recipients compared with the general population. Transpl Proc 37:960–961

    Article  CAS  Google Scholar 

  20. Tomlinson JS, Jarnagin WR, DeMatteo RP et al (2007) Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol 25:4575–4580

    Article  Google Scholar 

  21. Sillo TO, Beggs AD, Morton DG et al (2019) Mechanisms of immunogenicity in colorectal cancer. BJS (British Journal of Surgery) 106:1283–1297

    CAS  Google Scholar 

  22. Yokoyama I, Hayashi S, Sato E et al (1994) Enhancement of tumor proliferation by cyclosporine a in early phase of experimental hepatic metastasis. Jpn J Cancer Res: Gann 85:704–709

    Article  CAS  Google Scholar 

  23. Burra P, Rodriguez-Castro KI (2015) Neoplastic disease after liver transplantation: focus on de novo neoplasms. World J Gastroenterol 21:8753–8768

    Article  CAS  Google Scholar 

  24. Jung M (2015) National cancer screening programs and evidence-based healthcare policy in South Korea. Health Policy 119:26–32

    Article  Google Scholar 

  25. Wong G, Hope RL, Howard K et al (2019) One-time fecal immunochemical screening for advanced colorectal neoplasia in patients with CKD (Detect Study). J Am Soc Nephrol 30:1061–1072

    Article  CAS  Google Scholar 

  26. Hassan C, Antonelli G, Dumonceau JM et al (2020) Post-polypectomy colonoscopy surveillance: european society of gastrointestinal endoscopy (ESGE) guideline - Update 2020. Endoscopy 52:687–700

    Article  Google Scholar 

  27. Gupta S, Lieberman D, Anderson JC et al (2020) Recommendations for follow-up after colonoscopy and polypectomy: a consensus update by the us multi-society task force on colorectal cancer. Gastrointest Endosc 91:463-485.e465

    Article  Google Scholar 

  28. Pickhardt PJ, Choi JR, Hwang I et al (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (NSIT) (2020R1C11009345). This study was supported by a grant (2020IP0039) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.

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Authors and Affiliations

  1. Department of Colon & Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea

    Minsung Kim, Chan Wook Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu & Jin Cheon Kim

  2. Department of Hepatobiliary & Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea

    Shin Hwang & Sung-Gyu Lee

  3. Department of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea

    Young Hoon Kim & Duck Jong Han

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  1. Minsung Kim
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  2. Chan Wook Kim
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  3. Shin Hwang
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Corresponding author

Correspondence to Chan Wook Kim.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were under the institutional and/or national research committee's ethical standards and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The review board waived the requirement of informed consent, as this study was a retrospective analysis.

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Kim, M., Kim, C.W., Hwang, S. et al. Characteristics and Prognosis of Colorectal Cancer after Liver or Kidney Transplantation. World J Surg 45, 3206–3213 (2021). https://doi.org/10.1007/s00268-021-06219-9

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  • DOI: https://doi.org/10.1007/s00268-021-06219-9

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