Is thyroid cancer recurrence risk increased after transplantation?

J Clin Endocrinol Metab. 2013 Oct;98(10):3981-8. doi: 10.1210/jc.2013-1357. Epub 2013 Jul 24.

Abstract

Context: An increased cancer mortality is reported in transplanted patients.

Objective: This multicentric study aimed to investigate the rate of thyroid cancer recurrence after transplantation.

Results: Sixty-eight patients (35 male/33 female) with a history of both thyroid cancer and organ transplantation were recruited via two nationwide French networks. Histological analysis identified 58 papillary (88%), 5 follicular (7.5%), and 3 poorly differentiated cancer cases (4.5 %). Thirty-one patients (52%) presented high recurrence risk tumors. In the 36 patients with thyroid cancer diagnosed after transplantation, the 5-year disease-free survival (DFS) was 74.7% (SE: 7.3%). One patient died after progression of a poorly differentiated cancer. Persistent disease was observed in six high-risk patients. One of them underwent a second transplantation and disease remained stable after 5 years of follow-up. Thyroid cancer had been diagnosed before transplantation in 32 patients. One patient with cystic fibrosis and thyroid lung metastases at the time of lung transplantation underwent a 4-year remission. For the 31 patients in remission at the time of transplantation, the 5-year DFS was 93.1% (SE: 4.8%). Two patients with local recurrence presented subsequent remission. For the entire study population, the 5-year and 9-year DFS were 81.9% (SE: 5.5%) and 75.6% (SE: 7.9%), respectively. Recurrence or persistent disease occurred in patients with high-risk tumors.

Conclusions: The prognosis of thyroid cancer does not seem to be altered by transplantation. This suggests that a history of thyroid cancer should not be considered a contraindication.

Publication types

  • Multicenter Study

MeSH terms

  • Adenocarcinoma, Follicular / epidemiology*
  • Adenocarcinoma, Follicular / pathology
  • Adenocarcinoma, Follicular / surgery
  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Papillary / epidemiology*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / surgery
  • Child
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / pathology
  • Organ Transplantation / adverse effects*
  • Risk
  • Thyroid Neoplasms / epidemiology*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Treatment Outcome