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Ann Thorac Surg 2005;79:980-983
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

Lung Cancer After Heart Transplantation: A 17-Year Experience

^a Department of Cardiopulmonary Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA
^b Department of Hematology/Oncology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA
^c Department of Biostatistics and Epidemiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA
^d Department of Thoracic and Cardiovascular Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA

Accepted for publication May 7, 2004.

^* Address reprint requests to Dr Radovancevic, Texas Heart Institute, St. Luke's Episcopal Hospital, PO Box 20345, MC 2–114A, Houston, TX 77225–0345, USA
bradovancevic{at}sleh.com

BACKGROUND: The effects of heart transplantation on lung cancer incidence in heart transplant recipients are unclear.

METHODS: In an observational study, we retrospectively reviewed the charts of all patients undergoing heart transplantation at our institution from July 1982 to July 1999. Data on lung cancer incidence, risk factors, treatment, and outcome were collected.

RESULTS: Five hundred seventy-two patients (mean age, 50 ± 11 years; range, 18 to 73) were considered at risk for lung cancer. Of these, 324 (57%) had a more than 20 pack-year history of smoking before transplantation. Lung cancer developed in 2 patients 1 year or less after transplantation and in 8 patients more than 1 year after transplantation (incidence, 2.2 per 1,000 patients per year of follow-up). Non-small cell lung cancer was diagnosed in all cases. Median survival was 10.8 months (range, 2 to 37.5). Routine annual chest radiographs after transplantation enabled early diagnosis in 5 cases (stages Ia and IIa), which correlated with better mean survival (28.1 months [range, 19 to 37.5] versus 5.1 months [range, 2 to 10.8]; p = 0.0002).

CONCLUSIONS: The incidence of lung cancer in our population of heart transplant recipients appears to be no higher than in nontransplant populations with similar risk factors (ie, smoking and age). Routine radiographic imaging of transplant recipients may allow earlier detection of lung cancer and thus offer a survival benefit.

This article has been cited by other articles:

				P. Bagan, F. L. P. Barthes, and M. Riquet Prognosis of Lung Cancer in Heart Transplant Recipient Ann. Thorac. Surg., January 1, 2006; 81(1): 409 - 409. [Full Text] [PDF]

				K. Potaris, I. D. Gregoric, B. Radovancevic, and A. Vaporciyan Reply Ann. Thorac. Surg., January 1, 2006; 81(1): 409 - 409. [Full Text] [PDF]