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Article Dans Une Revue Clinics and Research in Hepatology and Gastroenterology Année : 2021

Risk factors of de novo malignancies after liver transplantation: a French national study on 11004 adult patients

1 ANTICIPE - Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers
2 Hôpital Côte de Nacre [CHU Caen]
3 CHU Caen
4 IP - Institut Pascal
5 UCBL - Université Claude Bernard Lyon 1
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 Physiopathologie et traitement des maladies du foie
8 CHB - Centre Hépato-Biliaire [Hôpital Paul Brousse]
9 CHU Pitié-Salpêtrière [AP-HP]
10 CHU Saint-Antoine [AP-HP]
11 Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
12 PIST - Pharmacologie des Immunosuppresseurs et de la Transplantation
13 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
14 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
15 Hôpital Beaujon [AP-HP]
16 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
17 Hôpital Henri Mondor
18 EPU Nice -Polytech'Nice-Sophia - Ecole Polytechnice Universitaire de Nice
19 CHU Nice - Centre Hospitalier Universitaire de Nice
20 TIMONE - Hôpital de la Timone [CHU - APHM]
21 Service de Néphrologie - Immunologie Clinique [Toulouse]
22 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
23 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
24 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
25 CHU Bordeaux
26 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
27 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
28 HCL - Hospices Civils de Lyon
29 CHU Trousseau [Tours]
30 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
31 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
Thierry Lobbedez
Philippe Segol
  • Fonction : Auteur
Armand Abergel
Christophe Duvoux
  • Fonction : Auteur
  • PersonId : 945796
Sylvie Radenne
Jérôme Dumortier

Résumé

Background: After liver transplantation (LT),de novo malignancies are one of the leading causes of late mortality. The aim of the present retrospective study was to identify the risk factors of de novo malignancies in a large cohort of LT recipients in France, using Fine and Gray competing risks regression analysis.Methods: The study population consisted in 11004 adults transplanted between 2000 and 2013, who had no history of pre-transplant malignancy, except primary liver tumor. A Cox model adapted to the identification of prognostic factors (competitive risks) was used.Results: From the entire cohort, one (or more)de novo malignancy was reported in 1480 L T recipients (13.45%). The probability to develop a de novo malignancy after LT was 2.07% at 1 year, 13.30% at 5 years, and 28.01% at 10 years. Of the known reported malignancies, the most common malignancies were hematological malignancy (22.36%), non-melanoma skin cancer (19.53%) and lung cancer (12.36%). According to Fine and Gray competing risks regression multivariate analysis, were significant risk factors for post-LT de novo malignancy: recipient age (Subdistribution Hazard Ratio (SHR) = 1.03 95%CI 1.03-1.04), male gender (SHR = 1.45 95%CI 1.27-1.67), non-living donor (SHR = 1.67 95%CI 1.14-2.38), a first LT (SHR = 1.35 95%CI 1.09-1.69) and the type of initial liver disease (alcohol-related liver disease (SHR = 1.63 95%CI 1.22-2.17), primary sclerosing cholangitis (SHR = 1.98 95%CI 1.34-2.91), and primary liver tumor (SHR = 1.88 95%CI 1.41-2.54)). Initial immunosuppressive regimen had no significant impact.Conclusion: The present study confirms that LT recipient characteristics are associated with the risk ofde novo malignancy and this underlines the need for personalized screening in order to improve survival.
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hal-03671648 , version 1 (15-03-2023)

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Paternité - Pas d'utilisation commerciale

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Mario Altieri, Olivier Sérée, Thierry Lobbedez, Philippe Segol, Armand Abergel, et al.. Risk factors of de novo malignancies after liver transplantation: a French national study on 11004 adult patients. Clinics and Research in Hepatology and Gastroenterology, 2021, 45 (4), pp.101514. ⟨10.1016/j.clinre.2020.07.019⟩. ⟨hal-03671648⟩
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