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. 2024 Sep 9:37:12127.
doi: 10.3389/ti.2024.12127. eCollection 2024.

Malignancies After Lung Transplantation

Caroline Stenman  1 , Andreas Wallinder  1   2 , Erik Holmberg  3   4 , Kristjan Karason  1   5   6 , Jesper Magnusson  1   7   6 , Göran Dellgren  1   2   6
Affiliations

Malignancies After Lung Transplantation

Caroline Stenman et al. Transpl Int. .

Abstract

Lung transplantation (LTx) is a well-known treatment for end-stage lung disease. This study aimed to report the incidence of cancer after LTx and long-term outcome among lung transplant recipients with a pretransplant diagnosis of cancer. Patients who underwent LTx between 1990-2016 were included in the study. Detection of cancer was obtained by cross-checking the study population with the Swedish Cancer Registry and the Cause-of-Death registry. A total of 614 patients were followed for a median of 5.1 years. In all, 159 malignancies were diagnosed. The excess risk of cancer or standardized incidence ratio (SIR) following LTx was 5.6-fold compared to the general Swedish population. The most common malignancies were non-melanoma skin cancer (NMSC) (SIR 76.5 (95%CI 61.7-94.8); non-Hodgkin lymphoma (SIR 23.5, 95%CI 14.8-37.2); and lung cancer (SIR 8.89, 95%CI 5.67-13.9). There was no significant difference in overall survival between those with and without a history of cancer before LTx (p = 0.56). In total, 159 malignancies were identified after LTx, which was a 5.6-fold higher relative to the general population. A history of previous cancer yields similar survival in selected recipients, compared to those without cancer prior to LTx.

Keywords: cancer; cohort study; epidemiology; heart transplantation; immunosuppression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

None
Graphical abstract
FIGURE 1
FIGURE 1
Etiology of lung failure as proportions of patients by diagnosis prior to lung transplantation. COPD, Chronic obstructive pulmonary disease.
FIGURE 2
FIGURE 2
(A–D) Cumulative probability of cancer and cumulative incidence of death. Cumulative incidence of competing risks cancer (panel (A)] and death [panel (B)], and related to time-era after lung transplantation. Both outcomes cancer and death need to be assessed together since they are competing outcomes. Estimates and 95% confidence intervals are shown under the number of patients at risk.
FIGURE 3
FIGURE 3
Pretransplant malignancy overall survival compared to those without. Estimates and 95% confidence intervals are shown under the number of patients at risk.
FIGURE 4
FIGURE 4
Pretransplant malignancy relative survival compared to those without. Estimates and 95% confidence intervals are shown under the number of patients at risk.
See this image and copyright information in PMC

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