Author/Authors :
Dobrindt, E. M Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Biebl, M Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Rademacher, S Department of Visceral - Transplant - Thoracic and Vascular Surgery - Universitätsklinikum Leipzig - Leipzig, Germany , Denecke, C Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Andreou, A Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Raakow, J Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Kröll, D Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Öllinger, R Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Pratschke, J Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany , Chopra, S. S Department of Surgery - Charité – Universitätsmedizin Berlin - Berlin, Germany
Abstract :
Background: Immunosuppression is essential after liver transplantation (LT). It, however, increases the
risk for cancer.
Objective: To evaluate the prevalence and outcome of upper gastrointestinal (GI) tract cancer in LT patients
and assess the perioperative risk of surgery for the upper GI malignancies post-LT.
Methods: 2855 patients underwent LT at our clinic from 1988 to 2018. 20 patients developed upper GI
cancer. Data were retrospectively extracted from our database. Analysis included patients’ specific data,
tumor histopathology and stage, the treatment given and survival.
Results: 23 patients developed upper GI malignancies (2 gastric and 18 esophageal cancers; 3 excluded),
translating to a incidence of 26.4 per 100,000 population per year. All patients were male. 80% showed
alcohol-induced cirrhosis before LT. Most of the tumors were diagnosed at a stage ≥III. 70% underwent
surgery and 78.6% developed postoperative complications. One-year-survival was 50%. Total survival
rate was 28.6% with a median follow-up of 10 months (range: 0–184).
Conclusion: Upper GI malignancies are more common after LT compared to the general population. Men
after LT, due to alcohol-induced liver cirrhosis, are at a higher risk. Upper GI surgery after LT can be safe,
but the severe risk for complications and a poor survival require strict indications.
Keywords :
Esophageal cancer , Immunosuppression , Squamous cell cancer , Esophagectomy
