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Ann Thorac Surg 2006;81:409
© 2006 The Society of Thoracic Surgeons

Correspondence

Prognosis of Lung Cancer in Heart Transplant Recipient

Patrick Bagan, MD, Françoise Le Pimpec Barthes, MD, Marc Riquet, MD

Department of Thoracic Surgery, Georges Pompidou European Hospital, Paris V University, 20-40 rue Leblanc, Paris, 75908 France

(Email: patrick.bagan{at}hop.egp.ap-hop-paris.fr).

To the Editor:

We read with interest the study by Potaris and co-workers [1] reporting their 17-year experience with lung cancer in heart transplant recipients.We agree with the consideration that smoking history is the major risk factor for lung cancer and that acceptable survival is observed only in early stage cancer. These observation imply, as we previously underlined [2], that careful search for bronchogenic carcinoma during follow-up in heavy smoking, heart transplant recipients may help improve survival. In the series of Potaris and colleagues [1], lung cancer was initially diagnosed on a routine follow-up chest roentgenogram in all cases, so it was considered to be sufficient. However, we and other authors [3, 4] have observed that standard chest roentgenograms missed lung cancer in 50% of cases and this method seemed to be insufficient to diagnose small lung cancer at an early stage. Regular computed tomographic scans of the chest are more appropriate and increase the rate of carcinologic complete resection (92%; 23 of 25 at our institution). Potaris and colleagues [1] also observed that survival of patients with late-stage tumors (stage IIIa or greater) was poor (mean, 5.1 months), but they did not discuss this problem. We suggested that long-term survival in this population depended mainly on lymph node involvement [2]. The rapid evolution of late-stage tumors can be explained by the inefficiency of adjuvant therapy. Traditional chemotherapy is generaly not performed in the transplant recipient because of comorbidities (mainly renal insufficiency) and immunosuppressive regimen. This limitation may contribute to the poor prognosis of advanced stage disease.


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  1. Potaris K, Radovanovic B, Thomas CD, et al. Lung cancer after heart transplantationa 17-year experience. Ann Thorac Surg 2005;79:980-983.[Abstract/Free Full Text]
  2. Bagan P, Assouad J, Berna P, et al. Immediate and long-term survival after surgery for lung cancer in heart transplant recipient Ann Thorac Surg 2005;79:438-442.[Abstract/Free Full Text]
  3. Goldstein DJ, Williams DL, Oz MC, et al. De novo solid malignancies after cardiac transplantation Ann Thorac Surg 1995;60:1783-1789.[Abstract/Free Full Text]
  4. Choi YH, Leung A, Miro S, et al. Primary bronchogenic carcinoma after heart or lung transplantationradiologic and clinical findings. J Thorac Imaging 2000;15:36-40.[Medline]



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Home page
 Ann. Thorac. Surg.Home page
K. Potaris, I. D. Gregoric, B. Radovancevic, and A. Vaporciyan
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Ann. Thorac. Surg., January 1, 2006; 81(1): 409 - 409.
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