Malignancy following heart transplantation: differences in incidence and prognosis between sexes – a multicenter cohort study. (12th March 2021)

• Record Type: Journal Article
• Authors: Minguito‐Carazo, Carlos; Gómez‐Bueno, Manuel; Almenar‐Bonet, Luis; Barge‐Caballero, Eduardo; González‐Vílchez, Francisco; Delgado‐Jiménez, Juan F.; María Arizón del Prado, José; Sousa‐Casasnovas, Iago; Mirabet‐Pérez, Sónia; González‐Costello, José; Sobrino‐Márquez, José Manuel; Pérez‐Villa, Félix; Díaz‐Molina, Beatriz; Rábago Juan‐Aracil, Gregorio; Blasco‐Peiró, Teresa; De la Fuente Galán, Luis; Garrido‐Bravo, Iris; García‐Guereta, Luis; Camino, Manuela; Albert‐Brotons, Dimpna C.; Muñiz, Javier; Crespo‐Leiro, Maria G.
• Is Part Of: Transplant international. Volume 34:Number 5(2021)
• Page Start: 882
• Page End: 893
• Publication Date: 2021-03-12
• Subjects: heart transplantation -- malignancy -- sexes; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13827
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: Male patients are at increased risk for developing malignancy postheart transplantation (HT); however, real incidence and prognosis in both genders remain unknown. The aim of this study was to assess differences in incidence and mortality related to malignancy between genders in a large cohort of HT patients. Incidence and mortality rates were calculated for all tumors, skin cancers (SCs), lymphoma, and nonskin solid cancers (NSSCs) as well as survival since first diagnosis of neoplasia. 5865 patients (81.6% male) were included. Total incidence rates for all tumors, SCs, and NSSCs were lower in females [all tumors: 25.7 vs. 44.8 per 1000 person‐years; rate ratio (RR) 0.68, (0.60–0.78), P < 0.001]. Mortality rates were also lower in females for all tumors [94.0 (77.3–114.3) vs. 129.6 (120.9–138.9) per 1000 person‐years; RR 0.76, (0.62–0.94), P = 0.01] and for NSSCs [125.0 (95.2–164.0) vs 234.7 (214.0–257.5) per 1000 person‐years; RR 0.60 (0.44–0.80), P = 0.001], albeit not for SCs or lymphoma. Female sex was associated with a better survival after diagnosis of malignancy [log‐rank p test = 0.0037; HR 0.74 (0.60–0.91), P = 0.004]. In conclusion, incidence of malignancies post‐HT is higher in males than in females, especially for SCs and NSSCs. Prognosis after cancer diagnosis is also worse in males.