Incidental diagnosis of gastric cancer in transplant recipients improves patient survival

TitleIncidental diagnosis of gastric cancer in transplant recipients improves patient survival
Publication TypeJournal Article
Year of Publication2002
AuthorsBuell JF, Husted T, Hanaway MJ, Peddi VR, Trofe J, Gross TG, Beebe TM, First MR, Woodle ES
Pagination754 - 8; - discussion - 758-60
Date PublishedOct
Accession Number12407362
Keywords*Organ Transplantation, Comorbidity, Comparative Study, Continental Population Groups, Heart Transplantation, Humans, Immunosuppressive Agents, Kidney Transplantation, Liver Transplantation, Middle Aged, Registries, Retrospective Studies, Stomach Neoplasms / epidemiology / mortality / *surgery, Survival Analysis, Survival Rate, Time Factors, Treatment Outcome, United States

BACKGROUND: Gastric cancer in the United States is often diagnosed at advanced stages, resulting in dismal outcomes. In the immunosuppressed transplant recipient population, little is known about the clinical staging and outcome of these compromised patients. METHODS: All US cases reported to the Israel Penn International Transplant Tumor Registry were retrospectively examined for patient demographics, immunosuppressive therapy, tumor characteristics, therapeutic modalities, and mortality. Statistical analysis was performed with Students t test, chi-square analysis, and log-rank analysis by the method of Kaplan-Meier. RESULTS: Gastric cancer was identified in 34 recipients: 28 (82%) were male; 24 (71%) were white. Mean age at diagnosis was 58 +/- 11 years. Twenty-four (71%) patients received kidney transplants, 7 (21%) received heart transplants, and 3 (9%) received liver transplants. Fifty percent received induction therapy, whereas 94% were maintained on calcineurin inhibitors and corticosteroids. Thirty-five percent of patients were diagnosed during evaluation for gastrointestinal symptoms, with the remaining cases discovered incidentally during endoscopy (53%) or during computed tomography (12%) performed for other reasons. Stage varied at presentation as follows: stage I (n = 6), stage II (n = 11), stage III (n = 13), and stage IV (n = 4). Incidental diagnoses resulted in a lower stage malignancy (P <.001 and="" greater="" survivals="" compared="" with="" those="" patients="" whose="" were="" diagnosed="" after="" being="" evaluated="" of="" gastrointestinal="" symptoms.="" conclusion:="" in="" the="" united="" states="" because="" gastric="" cancer="" transplant="" recipient="" is="" frequently="" identified="" at="" an="" earlier="" stage="" stages="" i="" ii="" than="" general="" population="" are="" equivalent="" despite="" continued="" administration="" immunosuppression.="" this="" early="" identification="" may="" be="" attributed="" to="" more="" frequent="" presymptom="" diagnosis="" staging="" resulting="" from="" incidental="" detection="" these="" malignancies="" during="" posttransplant="" upper="" endoscopy="" or="" computed="" tomography.="" has="" resulted="" a="" survival="" for="" entire="" group="" population.="">

Notify Library Reference ID251

Related Incidents