Old age, smoking after liver transplant increase incidence of malignancies
Monday, April 25, 2011 (Last Updated: 04/26/2011)
MONDAY, April 25 (HealthDay News) -- Liver transplant recipients who quit smoking after transplantation have a lower incidence of smoking-related malignancies (SRMs) compared with patients who continue smoking, according to a study published in the April issue of Liver Transplantation.
J. Ignacio Herrero, M.D., from the University Clinic of Navarra in Pamplona, Spain, and colleagues examined the incidence and risk factors for SRM of the lung, head and neck, esophagus, kidney, and urinary tract (excluding prostate) in 339 liver transplant recipients. In 135 recipients with a history of smoking, the SRM risk was compared between patients who stopped smoking versus those who continued smoking post transplantation. The patients were followed up for an average of 7.5 years.
The investigators identified 29 SRMs in 26 patients. The SRM rates at five and 10 years were 5 and 13 percent, respectively. Higher risk of developing SRMs was associated with older age, male sex, smoking, alcohol abuse, and immunosuppression with tacrolimus, while lower SRM risk was seen in patients with hepatitis C, transplant rejection, and a higher number of immunosuppressive drugs at three months. After adjusting for confounders, older age and smoking remained independent high risk factors for malignancy. In the smoker subgroup, active smoking and old age were related to a higher malignancy risk.
"The most relevant finding of this study is that liver transplant recipients who quit smoking had a lower rate of SRM than patients who continued to smoke," the authors write.
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