Ann Thorac Surg 2006;81:409
© 2006 The Society of Thoracic Surgeons
Correspondence
Reply
Konstantinos Potaris, MD
a
,
Igor D. Gregoric, MD
a
,
Branislav Radovancevic, MD
a
,
Ara Vaporciyan, MD
b
a Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX77030
b Department of Thoracic and Cardiovascular Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX77030
(Email: bradovancevic{at}sleh.com).
To the Editor:
We appreciate the comments of Bagan and colleagues [1] concerning our article [2]. They make the valid point that computed tomographic (CT) scanning may be more useful and effective than the chest roentgenogram for detecting lung cancer in heart transplant recipients on follow-up. However, CT screening trials are not yet conclusive on this point, and the cost to benefit ratio remains unknown. In any case, regular and consistent screening of heart transplant recipients for lung cancer, particularly those with a history of smoking, is important.
The correspondents also note that survival was poor among our patients with late-stage tumors (n = 5) and suggest that this poor survival may have been due to the inefficiency of adjuvant therapy. When called for, the use of adjuvant therapy in our patients was not compromised by immunosuppression, although renal insufficiency was undeniably a limiting factor. Moreover, as we stated in our article, the small number of lung cancer cases seen in our study population precludes making any sweeping claims about disease management and survival.
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References
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- Bagan P, Le Pimpec Barthes F, Riquet M. Prognosis of lung cancer in heart transplant recipient Ann Thorac Surg 2006;81:409.[Free Full Text]
- 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]
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