Incidence and long-term survival of patients with de novo head and neck carcinoma after liver transplantation

Head Neck. 2016 May;38(5):707-14. doi: 10.1002/hed.23943. Epub 2015 Jun 25.

Abstract

Background: Liver transplant recipients have an increased risk of developing de novo malignancies.

Methods: We conducted a prospective evaluation of clinicopathological data and predictors for overall survival (OS) in patients with head and neck squamous cell carcinoma (HNSCC) after liver transplantation (1988 to 2010).

Results: Thirty-three of 2040 patients who underwent liver transplantation (1.6%) developed de novo HNSCC. The incidence of HNSCC in liver transplant recipients with end-stage alcoholic liver disease (26) was 5%. After a median follow-up of 9 years, 1-year, 3-year, and 5-year OS rates were 74%, 47%, and 34%, respectively. Tumor size, cervical lymph node metastases, tumor site, and therapy (surgery only vs surgery and adjuvant radiotherapy [RT]/chemoradiotherapy [CRT] vs RT/CRT only; p < .0001) were significantly associated with OS in univariate analysis. However, surgery only predicted OS independently in multivariate analysis.

Conclusion: Early diagnosis and surgical treatment of de novo HNSCC are crucial to the outcome. HNSCC risk should be taken into close consideration during posttransplantation follow-up examinations, especially among patients with a positive history of smoking and alcohol consumption.

Keywords: de novo malignancies; head and neck cancer; head and neck squamous cell carcinoma (HNSCC); liver transplantation; survival.

MeSH terms

  • Adolescent
  • Adult
  • Carcinoma, Squamous Cell / etiology*
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / etiology*
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Incidence
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Prospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate
  • Young Adult