F-060LUNG TRANSPLANTATION IN UNEXPECTED EARLY STAGE CARCINOMA OF THE EXPLANTED LUNG: IS IT A CURE FOR THE CANCER?

• Published in: Interactive cardiovascular and thoracic surgery 2013-07, Vol.17 (suppl_1), p.S16-S16
• Main Authors: Klikovits, Thomas, Hoda, M.A., Ghanim, B., Zgud, S., Augustin, V., Muraközy, G., Klepetko, W., Jaksch, P.
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt288.60

Objectives The detection of cancer in a potential lung transplantation (LuTX) recipient may be a contraindication for transplantation. Undetected carcinoma in the explanted lung is a rare finding and may affect outcome. We intend to report about our experience with the incidence and survival of LuTX recipients and unknown pretransplant primary thoracic neoplasms. Methods We retrospectively reviewed our database of 1262 patients that underwent LuTX between 1989 and 2012 at our institution. Results The incidence of unexpected early stage thoracic tumours in this cohort was 1.03% (13 out of 1262). There were 8 men and 5 women with a mean age of 54.3 ± 9.02 years who received 1 single-lung and 12 bilateral transplants. The indication for LuTX was COPD in 10 and pulmonary fibrosis in 2 patients. One patient suffered from cystic fibrosis. The post-transplant histological diagnosis of the explanted lung revealed adenocarcinoma in 6 cases, squamous cell carcinoma in 3 cases, bronchioloalveolar carcinoma in 2 cases, malignant epitheloid pleural mesothelioma (MPM) in 1 and carcinoid tumour in 1 case. UICC 2009 TNM staging for the 12 patients with primary lung cancers revealed stage IA (pT1a/b N0) in 9 and IB (pT2a N0) in 2 cases. One patient was in stage IIA (pT1b N1). The patient with MPM was in IMIG/IASLC stage III. The patients underwent full post-transplant staging and no incidence of intrathoracic or distant metastasis was found. The 5-year survival rate was 72%. Patients underwent regular PET/ CT check-ups and no recurrence was detected at any time of follow-up. Conclusions Unexpected malignant lung tumours in explanted lungs at transplantation are rare, with an incidence of 1% in our population. In patients with early stage lung cancer, lung transplantation seems to be feasible without any recurrence or influence on survival. Disclosure All authors have declared no conflicts of interest.