Within 5 years following their transplant, at least 20% of lung transplant patients will be diagnosed with cancer. Transplant candidates with a history of pre-transplant malignancy must achieve remission requirements before being listed to reduce the chance of recurrence; nonetheless, these patients may have an inherent proclivity to develop recurrent tumors, which can be exacerbated by immunosuppression. For a study, researchers investigated whether pre-transplant malignancy was linked to an increased risk of getting any form of cancer following a lung transplant.
They conducted a single-center retrospective cohort analysis of lung transplant patients between January 2006 and December 2017. They utilized a proportional hazards regression model, which was adjusted for known cancer risk variables, to see if preTM was related to the likelihood of having one or more postTM following lung transplant.
During the research period, 497 adult patients had lung transplants, with 26 (5.2%) having pre-transplant malignancies. Prostate cancer was the most prevalent pre-transplant cancer diagnosis (17.2%), followed by breast cancer and basal cell carcinoma (13.8% each). With a total of 328 cancer diagnoses, 108 (22%) individuals acquired post-transplant malignancy. Skin cancer was the most frequent post-transplant malignancy (86.3%), followed by solid organ tumors (7.6%). Pre-transplant malignancy was linked with an adjusted HR of 3.24 (95% CI 1.71 to 6.14, P<0.001) for post-transplant malignancy development. Only three individuals had a recurrence of their pre-transplant cancer after the transplant.
History of pre-transplant malignancy was associated with a more than threefold increase in the chance of developing a post-transplant malignancy compared to recipients who had no prior history of cancer, with the majority of the malignancy being unrelated to the first malignancy. The findings emphasized the necessity of routine cancer screening in lung transplant recipients, particularly those with a history of pre-transplant cancer.