Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation

Background: De novo malignancies (DNMs) after liver transplantation (LT) are a major cause of long-term mortality. However, no definitive screening protocol has been established due to their diversity. This study aimed to evaluate DNM diagnosis methods, screening protocols, and prognoses. Methods: T...

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Main Authors: Sho Uemura, Yasushi Hasegawa, Hideaki Obara, Minoru Kitago, Hiroshi Yagi, Yuta Abe, Shutaro Hori, Masayuki Tanaka, Yutaka Nakano, Yuko Kitagawa
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Livers
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Online Access:https://www.mdpi.com/2673-4389/5/2/26
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author Sho Uemura
Yasushi Hasegawa
Hideaki Obara
Minoru Kitago
Hiroshi Yagi
Yuta Abe
Shutaro Hori
Masayuki Tanaka
Yutaka Nakano
Yuko Kitagawa
author_facet Sho Uemura
Yasushi Hasegawa
Hideaki Obara
Minoru Kitago
Hiroshi Yagi
Yuta Abe
Shutaro Hori
Masayuki Tanaka
Yutaka Nakano
Yuko Kitagawa
author_sort Sho Uemura
collection DOAJ
description Background: De novo malignancies (DNMs) after liver transplantation (LT) are a major cause of long-term mortality. However, no definitive screening protocol has been established due to their diversity. This study aimed to evaluate DNM diagnosis methods, screening protocols, and prognoses. Methods: This retrospective study included 231 adult LT recipients from April 1997 to March 2021. Disease-specific survival (DSS) was analyzed to assess the impact of screening on prognosis. Most recipients underwent serum tests every three months, annual gastrointestinal endoscopy, and chest-abdominal CT as part of routine surveillance. Results: Twenty-five DNMs were diagnosed in 22 patients, with median age of 61 years (range, 23–72), of whom 13 (59.1%) were female. The duration from transplantation to DNM diagnosis of DNM was 88 months (range, 4–195). DNM was diagnosed as follows: seven patients (31.8%) through screening (screening group) and 15 patients (68.2%) by other means (non-screening group). Curative treatment was achieved in all of the patients diagnosed by screening, whereas it was possible in only 60.0% of patients diagnosed by other means (<i>p</i> = 0.026). DSS in the screening group was significantly longer than that in the non-screening group (<i>p</i> = 0.024). Conclusions: While screening was associated with earlier-stage diagnosis and improved outcomes in some patients, the overall efficacy of the protocol requires further validation in larger studies.
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spelling doaj-art-11df98f8dbea4f6daae71ef5a9e8a0392025-08-20T03:16:19ZengMDPI AGLivers2673-43892025-06-01522610.3390/livers5020026Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver TransplantationSho Uemura0Yasushi Hasegawa1Hideaki Obara2Minoru Kitago3Hiroshi Yagi4Yuta Abe5Shutaro Hori6Masayuki Tanaka7Yutaka Nakano8Yuko Kitagawa9Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Surgery, Keio University School of Medicine, Tokyo 160-8582, JapanBackground: De novo malignancies (DNMs) after liver transplantation (LT) are a major cause of long-term mortality. However, no definitive screening protocol has been established due to their diversity. This study aimed to evaluate DNM diagnosis methods, screening protocols, and prognoses. Methods: This retrospective study included 231 adult LT recipients from April 1997 to March 2021. Disease-specific survival (DSS) was analyzed to assess the impact of screening on prognosis. Most recipients underwent serum tests every three months, annual gastrointestinal endoscopy, and chest-abdominal CT as part of routine surveillance. Results: Twenty-five DNMs were diagnosed in 22 patients, with median age of 61 years (range, 23–72), of whom 13 (59.1%) were female. The duration from transplantation to DNM diagnosis of DNM was 88 months (range, 4–195). DNM was diagnosed as follows: seven patients (31.8%) through screening (screening group) and 15 patients (68.2%) by other means (non-screening group). Curative treatment was achieved in all of the patients diagnosed by screening, whereas it was possible in only 60.0% of patients diagnosed by other means (<i>p</i> = 0.026). DSS in the screening group was significantly longer than that in the non-screening group (<i>p</i> = 0.024). Conclusions: While screening was associated with earlier-stage diagnosis and improved outcomes in some patients, the overall efficacy of the protocol requires further validation in larger studies.https://www.mdpi.com/2673-4389/5/2/26liver transplantationscreening protocolde novo malignancies
spellingShingle Sho Uemura
Yasushi Hasegawa
Hideaki Obara
Minoru Kitago
Hiroshi Yagi
Yuta Abe
Shutaro Hori
Masayuki Tanaka
Yutaka Nakano
Yuko Kitagawa
Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
Livers
liver transplantation
screening protocol
de novo malignancies
title Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
title_full Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
title_fullStr Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
title_full_unstemmed Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
title_short Potential Impact of Screening Examinations on Prognosis of De Novo Malignancies in Adult Patients After Liver Transplantation
title_sort potential impact of screening examinations on prognosis of de novo malignancies in adult patients after liver transplantation
topic liver transplantation
screening protocol
de novo malignancies
url https://www.mdpi.com/2673-4389/5/2/26
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