COMPARATIVE INCIDENCE OF DE NOVO NONLYMPHOID MALIGNANCIES AFTER LIVER TRANSPLANTATION UNDER TACROLIMUS USING SURVEILLANCE EPIDEMIOLOGIC END RESULT DATA1

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Abstract
An increased incidence of de novo nonlymphoid malignancies has been shown in immunocompromised patients. However, the true risk over time compared to the general population has not been determined. One thousand consecutive patients were carefully followed for an average of 77.8±11.1 (range, 56.3-96.3) months after primary liver transplantation at a single center. All de novo nonlymphoid malignancies were recorded. Each malignancy was compared with a standard Occupational Cohort Mortality Analysis Program population matched for age, sex, and length of follow-up using modified life table technique and surveillance epidemiology end result (SEER) data. Fifty-seven patients accounted for de novo malignancies and contributed 4795.3 total person years, a mean±SD of 36±21 (median, 36; range, 6-74) months after liver transplantation. Twenty-two of these malignancies were skin malignancies including two melanomas. Oropharyngeal cancers (n=7) were found to be 7.6 times higher (PP An increased incidence of de novo cancers in the chronically immunocompromised patient demands careful long-term screening protocols which will help to facilitate the diagnosis at an early stage of the disease. This is particularly true for oropharyngeal cancers where the risk is more than 7 times higher compared to SEER incidence data matched for age, sex, and length of follow-up.