Recipients of liver transplant (LT), particularly those with alcohol liver diseases (ALD), are at high risk for cancers. This study quantified the risk of head and neck (HN) and esophageal cancers in 2770 LT recipients transplanted in nine Italian centers during 1990-2010. The number of observed cancer cases in LT recipients was compared to the expected one to obtain standardized incidence ratios (SIRs) and 95% confidence intervals (CI). ALD was documented in 26.9% of the 2770 LT recipients, and 186 post-transplant cancers were diagnosed -including 33 cases of HN cancers (6 cases of tongue carcinoma; 10 cases of other carcinomas of the oral cavity; and 17 cases of larynx carcinoma) and nine cases of esophageal carcinoma. The 10-year cumulative risk for HN and esophageal carcinoma was 2.59%. Overall, HN cancers were nearly 5-fold more frequent in LT recipients than expected (SIR=4.8, 95% CI:3.3-6.8), while esophageal carcinoma was 9-fold more frequent than expected (SIR=9.1, 95% CI: 4.1-17.2). The magnitude of the risks of HN and esophageal carcinomas strongly differed according to the presence of ALD. SIRs ranged from 11.4 in LT with ALD to 2.2 for LT without ALD for all types of HN cancers, and from 23.9 to 2.9, respectively, for esophageal carcinoma. Particularly elevated SIRs in LT with ALD were noted for carcinomas of tongue (23.1, 95% CI:7.5-54.0) or larynx (12.7, 95% CI:6.3-49.2). Our findings confirmed and quantified the large cancer excess risk in LT recipients with ALD. The risk magnitude and the prevalence of ALD herein documented stress the need of timely and specifically tailored programs for the prevention and early diagnosis of cancer among LT recipients.

Citation Format: Diego Serraino. Head and neck and esophageal cancers after liver transplant: Results from a multicenter cohort study. Italy, 1997-2010. [abstract]. In: Proceedings of the Thirteenth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2014 Sep 27-Oct 1; New Orleans, LA. Philadelphia (PA): AACR; Can Prev Res 2015;8(10 Suppl): Abstract nr B02.