Abstract | BACKGROUND:
Lung transplantation (LTx) remains the best option for selected patients with end-stage lung disease. Long-term survival is hampered by the development of chronic allograft dysfunction, which is the main reason for mortality at 3 to 5 years after LTx. Prevalence of and mortality due to solid-organ tumors also increases and we specifically investigated the development of primary bronchial carcinoma (BC) and its outcome after LTx. METHODS: From January 2000 until June 2011, 494 lung and heart-lung transplantations were performed. Among this population, 13 patients developed bronchial carcinoma at 41 ± 27 (mean ± SD) months after LTx. Of these 13 patients, there were 9 men and 4 women. They were transplanted at a mean age of 59 ± 2.8 years; 8 patients were transplanted for emphysema and 5 for pulmonary fibrosis. RESULTS: Nine of 92 single LTx patients (transplanted for emphysema or lung fibrosis) developed a bronchial carcinoma in their native lung, whereas only 4 of 224 bilateral LTx patients (also for emphysema or fibrosis) developed a bronchial carcinoma (p = 0.0026). At diagnosis, 4 patients had local disease (cT1N0M0 and cT2N0M0), whereas all others had locoregionally advanced or metastatic disease. Five patients were surgically treated; however, 1 had unforeseen N2 disease with additional pleural metastasis at surgery. All other patients (except 2 who died very soon after diagnosis) were treated with chemotherapy with or without radiotherapy. The median survival after diagnosis was only 10 ± 7 months, with a significant survival difference between patients with limited and extensive disease (p = 0.037). The latter had a median survival of only 6 months compared with 21 months for patients with limited stages of bronchial carcinoma. CONCLUSIONS:
Bronchial carcinoma, especially of the native lung after single LTx, is a significant problem and the survival after diagnosis is very poor, although patients with limited (operable) disease tend to have better results.
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Authors | Jonas Yserbyt, Geert M Verleden, Lieven J Dupont, Dirk E Van Raemdonck, Christophe Dooms |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 31
Issue 6
Pg. 585-90
(Jun 2012)
ISSN: 1557-3117 [Electronic] United States |
PMID | 22425236
(Publication Type: Journal Article)
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Copyright | Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. |
Topics |
- Carcinoma, Bronchogenic
(epidemiology, mortality, therapy)
- Combined Modality Therapy
- Drug Therapy
- Female
- Humans
- Lung Neoplasms
(epidemiology, mortality, therapy)
- Lung Transplantation
- Male
- Middle Aged
- Postoperative Period
- Prevalence
- Pulmonary Emphysema
(surgery)
- Pulmonary Fibrosis
(surgery)
- Radiotherapy
- Retrospective Studies
- Survival Rate
- Treatment Outcome
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