TY - JOUR
T1 - A 3-Decade Analysis of Pancreatic Adenocarcinoma after Solid Organ Transplant
AU - Corral, Juan E.
AU - Croome, Kristopher P.
AU - Keaveny, Andrew P.
AU - Brahmbhatt, Bhaumik
AU - Kröner, Paul T.
AU - Wijarnpreecha, Karn
AU - Goswami, Rohan M.
AU - Raimondo, Massimo
AU - Wallace, Michael B.
AU - Bi, Yan
AU - Mousa, Omar Y.
N1 - Funding Information:
Supported in part by Health Resources and Services Administration contract 234-2005-37011C.
Funding Information:
J.E.C. received a travel grant from Abbvie, Inc, and minor food and beverage from Boston Scientific and Cook Medical. M.B.W. is a consultant at Virgo, Inc, Cosmo/Aries Pharmaceuticals, Anx Robotica (2019), and Covidien; received research grants from Fujifilm, Boston Scientific, Olympus, Medtronic, Ninepoint Medical, and Cosmo/Aries Pharmaceuticals; and received stock/stock options from Virgo, Inc. M.B.W. does consulting on behalf of Mayo Clinic: GI Supply (2018), EndoKey, Endostart, and Boston Scientific and received minor food and beverage from Synergy Pharmaceuticals, Boston Scientific, and Cook Medical. The other authors declare no conflict of interests.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective Solid organ transplant (SOT) recipients have moderately increased risk of pancreatic adenocarcinoma (PAC). We evaluated the incidence and survival of PAC in 2 cohorts and aimed to identify potential risk factors. Methods This study performed a retrospective cohort analysis. Cohort A was extracted from the United Network of Organ Sharing data set and cohort B from SOT recipients evaluated at 3 Mayo Clinic transplant centers. The primary outcome was age-Adjusted annual incidence of PAC. Descriptive statistics, hazard ratios, and survival rates were compared. Results Cohort A and cohort B included 617,042 and 29,472 SOT recipients, respectively. In cohort A, the annual incidence rate was 12.78 per 100,000 in kidney-pancreas, 13.34 in liver, and 21.87 in heart-lung transplant recipients. Receiving heart-lung transplant, 50 years or older, and history of cancer (in either recipient or donor) were independent factors associated with PAC. Fifty-Two patients developed PAC in cohort B. Despite earlier diagnosis (21.15% with stage I-II), survival rates were similar to those reported for sporadic (non-SOT) patients. Conclusions We report demographic and clinical risk factors for PAC after SOT, many of which were present before transplant and are common to sporadic pancreatic cancer. Despite the diagnosis at earlier stages, PAC in SOT portends a very poor survival.
AB - Objective Solid organ transplant (SOT) recipients have moderately increased risk of pancreatic adenocarcinoma (PAC). We evaluated the incidence and survival of PAC in 2 cohorts and aimed to identify potential risk factors. Methods This study performed a retrospective cohort analysis. Cohort A was extracted from the United Network of Organ Sharing data set and cohort B from SOT recipients evaluated at 3 Mayo Clinic transplant centers. The primary outcome was age-Adjusted annual incidence of PAC. Descriptive statistics, hazard ratios, and survival rates were compared. Results Cohort A and cohort B included 617,042 and 29,472 SOT recipients, respectively. In cohort A, the annual incidence rate was 12.78 per 100,000 in kidney-pancreas, 13.34 in liver, and 21.87 in heart-lung transplant recipients. Receiving heart-lung transplant, 50 years or older, and history of cancer (in either recipient or donor) were independent factors associated with PAC. Fifty-Two patients developed PAC in cohort B. Despite earlier diagnosis (21.15% with stage I-II), survival rates were similar to those reported for sporadic (non-SOT) patients. Conclusions We report demographic and clinical risk factors for PAC after SOT, many of which were present before transplant and are common to sporadic pancreatic cancer. Despite the diagnosis at earlier stages, PAC in SOT portends a very poor survival.
KW - BMI-body mass index
KW - CI-confidence interval
KW - CMP-cardiomyopathy
KW - CMV-cytomegalovirus
KW - COPD-chronic obstructive pulmonary disease
KW - EBV-Epstein-Barr virus
KW - HBV-hepatitis B virus
KW - HBsAg-hepatitis B surface antigen
KW - HCC-hepatocellular carcinoma
KW - HCV-hepatitis C virus
KW - HLA-human leukocyte antigen
KW - HR-hazard ratio
KW - IPMN-intraductal mucinous papillary neoplasm
KW - Ig-immunoglobulin
KW - MMF-mycophenolate mofetil
KW - NASH-nonalcoholic steatohepatitis
KW - PAC-pancreatic adenocarcinoma
KW - PBC-primary biliary cirrhosis
KW - PSC-primary sclerosing cholangitis
KW - SD-standard deviation
KW - SOT-solid organ transplantation
KW - TRF-transplant recipient follow-up
KW - UNOS-United Network of Organ Sharing
KW - adenocarcinoma
KW - incidence
KW - organ transplantation
KW - pancreatic cancer
KW - survival
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UR - http://www.scopus.com/inward/citedby.url?scp=85098130210&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001722
DO - 10.1097/MPA.0000000000001722
M3 - Article
C2 - 33370023
AN - SCOPUS:85098130210
SN - 0885-3177
VL - 50
SP - 54
EP - 63
JO - Pancreas
JF - Pancreas
IS - 1
ER -