gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

De Novo Tumors after Liver Transplantation

Meeting Abstract

  • corresponding author presenting/speaker Vera Schellerer - Chirurgische Universitätsklinikum Erlangen-Nürnberg, Erlangen, Deutschland
  • Thomas Förtsch - Chirurgische Universitätsklinikum Erlangen-Nürnberg, Erlangen
  • Werner Hohenberger - Chirurgische Universitätsklinikum Erlangen-Nürnberg, Erlangen
  • Süleyman Yedibela - Chirurgische Universitätsklinikum Erlangen-Nürnberg, Erlangen

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP617

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Veröffentlicht: 20. März 2006

© 2006 Schellerer et al.
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Background: De novo tumor (DNT) is a serious complication and a major cause of death in liver transplanted patients due to long-term immunosuppression. The object of this study was to assess the incidence, risk factors and outcome of DNT, depending on the reason of transplantation, the immunosuppression and the preexisting risk factors prior to transplantation.

Methods: We retrospectively analyzed 255 patients after liver transplantation performed from January 1992 to February 2004. We included 203 patients in our study who had survived at least 1 year after transplantation. Patients with malignancy prior to transplantation were also excluded from analysis.

Results: Twenty-one patients (9.8%) developed 25 DNTs. The most frequent neoplasms were gastrointestinal malignancies (n=7). Other DNTs were respiratory malignancies (n=5), oropharyngeal malignancies (n=4), urogenital malignancies (n=4), lymphoproliferative disease (n=2) and skin cancer (n=3). Two patients developed multiple malignancies. The mean time of presentation of DNT was 50.9 month after transplantation (range 0.5 to 129 months).The mean age at diagnosis of malignancy was 57 years (range 44 to 75 years). The type of immunosuppression did not influence tumoral type, although most patients received cyclosporine A in combination with azathioprine, antithymocyte globulin and corticoids (88%). Reason for transplantation in the DNT group was in 74% nutritive toxic liver cirrhosis. Other reasons were Hepatitis virus B infection, liver cirrhosis of unknown etiology, primary billiary cirrhosis and autoimmune disease. Survival after diagnosis of DNT was 28 month (range 2-103 month) for all patients. The mean survival time for patients receiving no surgical therapy was 15 month and all patients died within 47 month. If a surgical therapy was possible the mean survival was 48 month. Six of 8 patients are still alive.

Conclusion: DNTs are frequent after liver transplantation and their incidence is greater than that in general population. Because their clinical course is more aggressive, regular follow-up of these patients is essential for early diagnosis. In selected cases surgical therapy can result in long-term survival.