Carcinoma of the lung after heart transplantation

Daniel J. Goldstein, John H M Austin, Nancy Zuech, Deborah L. Williams, Marc B. Stoopler, Robert E. Michler, Larry L. Schulman

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

We have recently noted an unexpected high incidence of lung cancer in our population of cardiac allograft recipients. We conducted a retrospective review of cardiac transplantation at our institution to investigate the incidence, clinical course, and outcome of patients who developed lung cancer following heart transplantation. Nine patients - each with a history of smoking at least 30 pack-years - developed lung cancer following cardiac transplantation, for an incidence of 1.56% of patients at risk. Eight of the patients were male ≤50 years of age, representing 3.3% of the male transplant recipients in this age group. The interval from transplantation to diagnosis clustered around 3-5 years after transplantation, but in two instances (22%), a neoplasm was discovered within 6 months of transplantation. Almost half of the cancers were discovered incidentally, despite routine radiographic surveillance. Seven of 9 (78%) patients had stage IV disease at presentation. Median survival after diagnosis was 3 months, and five of the seven patients who died survived less than 4 months after diagnosis. Two patients remain alive 2 and 12 months after diagnosis. We conclude that cardiac transplant recipients are at increased risk for development of lung cancer. Patients with a moderate to heavy smoking history might well be advised to undergo chest CT scanning in an aggressive search for occult lung cancer before cardiac transplantation is considered further. Finally, despite frequent radiologic examinations, these lung cancers are often diagnosed incidentally, are far advanced at the time of diagnosis, are not surgically resectable, and are poorly responsive to adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)772-775
Number of pages4
JournalTransplantation
Volume62
Issue number6
StatePublished - Sep 27 1996
Externally publishedYes

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Heart-Lung Transplantation
Carcinoma
Lung Neoplasms
Heart Transplantation
Transplantation
Incidence
Smoking
Allografts
Neoplasms
Thorax
Age Groups
History
Survival

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Goldstein, D. J., Austin, J. H. M., Zuech, N., Williams, D. L., Stoopler, M. B., Michler, R. E., & Schulman, L. L. (1996). Carcinoma of the lung after heart transplantation. Transplantation, 62(6), 772-775.

Carcinoma of the lung after heart transplantation. / Goldstein, Daniel J.; Austin, John H M; Zuech, Nancy; Williams, Deborah L.; Stoopler, Marc B.; Michler, Robert E.; Schulman, Larry L.

In: Transplantation, Vol. 62, No. 6, 27.09.1996, p. 772-775.

Research output: Contribution to journalArticle

Goldstein, DJ, Austin, JHM, Zuech, N, Williams, DL, Stoopler, MB, Michler, RE & Schulman, LL 1996, 'Carcinoma of the lung after heart transplantation', Transplantation, vol. 62, no. 6, pp. 772-775.
Goldstein DJ, Austin JHM, Zuech N, Williams DL, Stoopler MB, Michler RE et al. Carcinoma of the lung after heart transplantation. Transplantation. 1996 Sep 27;62(6):772-775.
Goldstein, Daniel J. ; Austin, John H M ; Zuech, Nancy ; Williams, Deborah L. ; Stoopler, Marc B. ; Michler, Robert E. ; Schulman, Larry L. / Carcinoma of the lung after heart transplantation. In: Transplantation. 1996 ; Vol. 62, No. 6. pp. 772-775.
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