Outcomes of Colorectal Cancer Arising in Solid Organ Transplant Recipients

• Published in: Journal of gastrointestinal surgery 2014-03, Vol.18 (3), p.599-604
• Main Authors: Merchea, Amit, Abdelsattar, Zaid M., Taner, Timucin, Dean, Patrick G., Colibaseanu, Dorin T., Larson, David W., Dozois, Eric J.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - secondary; Adenocarcinoma - surgery; Aged; Aged, 80 and over; Anastomotic Leak - etiology; Colectomy - adverse effects; Colon, Ascending; Colon, Transverse; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Colostomy - adverse effects; Cytomegalovirus; Disease-Free Survival; Gastroenterology; Heart; Humans; Ileostomy - adverse effects; Ileus - etiology; Length of Stay; Liver; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Neoplasm Metastasis; Neoplasm Staging; Organ Transplantation; Original Article; Patients; Polyps; Proctocolectomy, Restorative - adverse effects; Retrospective Studies; Surgery; Surgical Wound Infection - etiology; Survival Rate; Time Factors; Transplants & implants; Viruses
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-013-2402-3

Introduction The incidence of colorectal cancer posttransplantation is unclear. Limited reports exist and have conflicting conclusions. We aimed to review the clinical features and oncologic outcomes of colorectal cancer in transplant recipients at our institution. Methods A retrospective review of all patients diagnosed with colorectal cancer after solid organ transplantation between 2000 and 2011 was conducted. Clinical features and outcomes were reviewed. Results Twenty of 3,946 patients were identified. The most common single organ transplanted was the kidney ( n  = 8). Six patients had multiorgan transplantation. Median age of diagnosis of cancer was 64.3 years, and median time from transplant to diagnosis of cancer was 8.7 years. Ten patients were symptomatic at presentation. Cancer was identified on routine colonoscopy in seven patients. Tumors were most commonly found in the right colon ( n  = 14, 70 %). Six patients had stage IV disease at presentation. Short-term morbidity was identified in 11 patients. Postoperative mortality occurred in one patient. Median follow-up was 2.47 years. Overall survival at 5 years was 69 %, and disease-free survival was 68 %. Distant recurrence was seen in 3 (15 %) patients. Conclusion Colorectal cancer in these patients is rare, and surgery can be done safely. Vigilant screening must be maintained in this patient population.