Thyroid cancer recurrence risk after transplantation: Single center experience
Ozlem Turhan Iyidir1, Pinar Altay1, Mahir Kirnap2, Nazli Gulsoy Kirnap1, Neslihan Bascıl Tutuncu1, Mehmet A. Haberal2.
1Endocrinology and Metabolic Diseases, Baskent University, Ankara, Turkey; 2Transplantation, Baskent University, Ankara, Turkey
Background: Organ transplantation is a life saving treatment option for most types of end stage organ failure. Transplant outcomes have improved over time however increased risk of malignancy has been reported in transplant recipients. Thyroid diseases including thyroid cancer may worsen after transplantation mainly due to a consequence of immunosuppression. We aimed to evaluate the risk of recurrence and mortality of thyroid cancer after solid organ transplantation.
Patients and Methods: Between 1975 and 2019 total 654 liver and 3052 kidney transplantations were performed in Başkent University. We identified 14 patients with thyroid cancer. Twelve of 14 patients were kidney transplant recipients and 2 were liver transplant recipients.
Results: Fourteen patients (7 males / 7 females) with a history of both organ transplantation and thyroid cancer were recruited for this study. Median age of the patients was 42 (31-70) years. All of patients underwent total thyroidectomy. Thirteen of the 14 patients had papillary cancer, one patient had follicular cancer. Nine of the patients (64.3%) had multifocal disease. All patients had stage I disease and also were in low risk group according to ATA classification. Median follow up time was 6.9 (1.3-14.6) years. After initial treatment 13 of 14 patients were fully cured and healthy. During follow up time there were no signs of local recurrence or distant metastasis in the remaining 13 patients. None of the patients died from thyroid cancer.
Conclusion: In our study there was not increased recurrence rate and mortality of thyroid cancer in transplant recipients. Our results suggest that solid organ transplantation does not influence prognosis of thyroid cancer especially in low risk patients. There is a concern about progression of previously treated cancer after transplantation.
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