Incidental diagnosis of gastric cancer in transplant recipients improves patient survival

Background. Gastric cancer in the United States is often diagnosed at advanced stages, resulting in dismal outcomes. In the immunosuppressed transplant recipient population, little is known about the clinical staging and outcome of these compromised patients. Methods. All US cases reported to the Is...

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Bibliographic Details
Published in:Surgery 2002-10, Vol.132 (4), p.754-760
Main Authors: Buell, Joseph F., Husted, Thomas, Hanaway, Michael J., Peddi, V.Ram, Trofe, Jennifer, Gross, Thomas G., Beebe, Thomas M., First, M.Roy, Woodle, E.Steve
Format: Article
Language:English
Subjects:
Biological and medical sciences
Comorbidity
Continental Population Groups
Heart Transplantation
Humans
Immunosuppressive Agents
Kidney Transplantation
Liver Transplantation
Medical sciences
Middle Aged
Organ Transplantation
Registries
Retrospective Studies
Stomach Neoplasms - epidemiology
Stomach Neoplasms - mortality
Stomach Neoplasms - surgery
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Survival Rate
Time Factors
Treatment Outcome
United States
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Summary:Background. Gastric cancer in the United States is often diagnosed at advanced stages, resulting in dismal outcomes. In the immunosuppressed transplant recipient population, little is known about the clinical staging and outcome of these compromised patients. Methods. All US cases reported to the Israel Penn International Transplant Tumor Registry were retrospectively examined for patient demographics, immunosuppressive therapy, tumor characteristics, therapeutic modalities, and mortality. Statistical analysis was performed with Students t test, chi-square analysis, and log-rank analysis by the method of Kaplan-Meier. Results. Gastric cancer was identified in 34 recipients: 28 (82%) were male; 24 (71%) were white. Mean age at diagnosis was 58 ± 11 years. Twenty-four (71%) patients received kidney transplants, 7 (21%) received heart transplants, and 3 (9%) received liver transplants. Fifty percent received induction therapy, whereas 94% were maintained on calcineurin inhibitors and corticosteroids. Thirty-five percent of patients were diagnosed during evaluation for gastrointestinal symptoms, with the remaining cases discovered incidentally during endoscopy (53%) or during computed tomography (12%) performed for other reasons. Stage varied at presentation as follows: stage I (n = 6), stage II (n = 11), stage III (n = 13), and stage IV (n = 4). Incidental diagnoses resulted in a lower stage malignancy (P
ISSN:0039-6060
1532-7361
DOI:10.1067/msy.2002.127670