PURPOSE
Immunosuppression used in transplantation is associated with an increased incidence of various cancers. Although the incidence of colorectal cancer in transplant patients seems to be equal to nontransplant population, the effects of immunosuppression on patients who develop colorectal cancer are not well defined. The purpose of this study was to define the characteristics and survival patterns of transplant patients developing de novo colorectal cancer.
METHODS
The Israel Penn International Transplant Tumor Registry was queried for patients with colorectal cancer. Analysis included patient demographics, age at transplantation and colorectal cancer diagnosis, tumor stage, and survival. Age and survival rates were compared to United States population-based colorectal cancer statistics using the National Cancer Institute Surveillance Epidemiology and End Results database.
RESULTS
A total of 150 transplant patients with de novo colorectal cancer were identified: 93 kidney, 29 heart, 27 liver, and 1 lung. Mean age at transplantation was 53 years. Age at transplantation and colorectal cancer diagnosis was not significant for gender, race, or stage of disease. Compared to National Cancer Institute Surveillance Epidemiology and End Results database, transplantat patients had a younger mean age at colorectal cancer diagnosis (58 vs. 70 years; P < 0.001), and a worse five-year survival (overall, 44 vs. 62 percent, P < 0.001; Dukes A&B, 74 vs. 90 percent, P < 0.001; Dukes C, 20 vs. 66 percent, P < 0.001; and Dukes D, 0 vs. 9 percent, P = 0.08).
CONCLUSIONS
Transplant patients develop colorectal cancer at a younger age and exhibit worse five-year survival rates than the general population. These data suggest that chronic immunosuppression results in a more aggressive tumor biology. Frequent posttransplantation colorectal cancer screening program may be warranted.
Similar content being viewed by others
REFERENCES
URREA. UNOS. 2002 annual report of the U.S. Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients: transplant data 1992–2001. Available at: http://www.optn.org/data/annualReport.asp. Accessed October 19, 2002.
I Penn (1993) ArticleTitleTumors after renal and cardiac transplantation Hematol Oncol Clin North Am 7 431–45 Occurrence Handle1:STN:280:ByyB38vktlQ%3D Occurrence Handle8468275
I Penn (2000) ArticleTitleCancers in renal transplant recipients Adv Ren Replace Ther 7 147–56 Occurrence Handle1:STN:280:DC%2BD3c3kt1yhtA%3D%3D Occurrence Handle10782732
EB Haagsma VE Hagens M Schaapveld et al. (2001) ArticleTitleIncreased cancer risk after liver transplantation: a population-based study J Hepatol 34 84–91 Occurrence Handle10.1016/S0168-8278(00)00077-5 Occurrence Handle1:STN:280:DC%2BD3M7ptlCnuw%3D%3D Occurrence Handle11211912
I Blohmé H Brynger (1985) ArticleTitleMalignant disease in renal transplant patients Transplantation 39 23–5 Occurrence Handle3880960
I Penn (1986) ArticleTitleCancers of the anogenital region in renal transplant recipients. Analysis of 65 cases Cancer 58 611–6 Occurrence Handle1:STN:280:BimB2s7ltFY%3D Occurrence Handle3524788
T Stewart R Henderson H Grayson G Opelz (1997) ArticleTitleReduced incidence of rectal cancer, compared to gastric and colon cancer, in a population of 73,076 men and women chronically immunosuppressed Clin Cancer Res 3 51–5 Occurrence Handle1:STN:280:DyaK1M%2FjsFamsA%3D%3D Occurrence Handle9815537
C Ebisui M Okazaki T Kanai et al. (2000) ArticleTitleClinicopathological study of colorectal cancers after renal transplantation. Transplant Proc 32 1984–5
MH Trivedi S Agrawal MS Muscato MH Metzler JB Marshall (1999) ArticleTitleHigh grade, synchronous colon cancer after renal transplantation: were immunosuppressive drugs to blame? Am J Gastroenterol 94 3359–61 Occurrence Handle10.1016/S0002-9270(99)00612-7 Occurrence Handle1:STN:280:DC%2BD3c%2FjtFShsg%3D%3D Occurrence Handle10566744
G Letsou GH Ballantyne IM Zdon RM Cambria IM Modlin (1986) ArticleTitleRectal carcinoma in a renal transplant patient: long-term complication of immunosuppression? Dis Colon Rectum 29 133–5 Occurrence Handle1:STN:280:BimC3cjmslM%3D Occurrence Handle3510835
Ries LAG, Eisner MP, Kosary CL, et al. eds. SEER cancer statistics review, 1975–2000. Bethesda, MD: National Cancer Institute, http://seer.cancer.gov/csr/1975_2000, 2003.
BF Hankey LA Ries BK Edwards (1999) ArticleTitleThe surveillance, epidemiology and end results program: a national resource Cancer Epidemiol Biomarkers Prev 8 1117–21 Occurrence Handle1:STN:280:DC%2BD3c%2FnvVGjug%3D%3D Occurrence Handle10613347
EV Loftus HI Aguilar WJ Sandborn et al. (1998) ArticleTitleRisk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis following orthotopic liver transplantation Hepatology 27 685–90 Occurrence Handle10.1002/hep.510270308 Occurrence Handle9500695
O Fausa E Schrumpf K Elgjo (1991) ArticleTitleRelationship of inflammatory bowel disease and primary sclerosing cholangitis Semin Liver Dis 11 31–9 Occurrence Handle1:STN:280:By6B283mslU%3D Occurrence Handle2047887
R Mayer WD Wong DA Rothenberger SM Goldberg RD Madoff (1999) ArticleTitleColorectal cancer in inflammatory bowel disease: a continuing problem Dis Colon Rectum 42 343–7 Occurrence Handle1:STN:280:DyaK1M3jvVaksg%3D%3D Occurrence Handle10223754
I Yokoyama S Hayashi E Sato et al. (1994) ArticleTitleEnhancement of tumor proliferation by cyclosporin A in early phase of experimental hepatic metastasis Jpn J Cancer Res 85 704–9 Occurrence Handle1:CAS:528:DyaK2cXmt1Whsrw%3D Occurrence Handle8071112
W Vrie ParticleVan de RL Marquet AM Eggermount (1997) ArticleTitleCyclosporin A enhances locoregional metastasis of the CC531 rat colon tumour J Cancer Res Clin Oncol 123 21–4 Occurrence Handle8996536
ER Fearon B Vogelstein (1990) ArticleTitleA genetic model for colorectal tumorigenesis Cell 61 759–67 Occurrence Handle10.1016/0092-8674(90)90186-I Occurrence Handle1:CAS:528:DyaK3cXktlyhtrg%3D Occurrence Handle2188735
SJ Winawer AG Zauber MN Ho et al. (1993) ArticleTitlePrevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Work Group N Engl J Med 329 1977–81 Occurrence Handle10.1056/NEJM199312303292701 Occurrence Handle1:STN:280:ByuD28jisFw%3D Occurrence Handle8247072
M Parikshak SE Pawlak JC Eggenberger CS Lee EJ Szilagy DA Margolin (2002) ArticleTitleThe role of endoscopic colon surveillance in the transplant population Dis Colon Rectum 45 1655–60 Occurrence Handle12473890
T Atassi PJ Thuluvath (2003) ArticleTitleRisk of colorectal adenoma in liver transplant recipients compared to immunocompetent control population undergoing routine screening colonoscopy J Clin Gastroenterol 37 72–3 Occurrence Handle10.1097/00004836-200307000-00018 Occurrence Handle12811214
JF Trotter (2001) ArticleTitleCancer surveillance following orthotopic liver transplantation Gastrointest Endosc Clin N Am 11 199–214 Occurrence Handle1:STN:280:DC%2BD3M3itlKjtg%3D%3D Occurrence Handle11175982
JF Buell T Husted MJ Hanaway et al. (2002) ArticleTitleGastric cancer in transplant recipients: detection of malignancy by aggressive endoscopy. Transplant Proc 34 1784–5 Occurrence Handle10.1016/S0041-1345(02)03076-2 Occurrence Handle12176575
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Papaconstantinou, H., Sklow, B., Hanaway, M. et al. Characteristics and Survival Patterns of Solid Organ Transplant Patients Developing De Novo Colon and Rectal Cancer. Dis Colon Rectum 47, 1898–1903 (2004). https://doi.org/10.1007/s10350-004-0674-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10350-004-0674-0