Increased incidence of oropharyngeal squamous cell carcinomas after liver transplantation for alcoholic cirrhosis

Background The aim of this study was to describe the features of posttransp lantation tumors observed in a series of liver transplant recipients with s pecial reference to patients receiving a transplant for alcoholic cirrhosis . Methods. Among 171 consecutive liver transplant recipients, 90 patients who had received a first liver allograft for cirrhosis were studied. After liv er transplantation, detection of de novo malignancies was prospectively und ertaken and the characteristics of the patients in whom tumors occurred wer e compared with those in whom tumors did not develop. Results. With a follow-up of 45.2 +/- 21.2 months, 11 tumors were observed in 90 patients (overall incidence of 12.2%). The incidence of tumors was hi gher in patients receiving a transplant for alcoholic cirrhosis than in pat ients receiving a transplant for nonalcoholic cirrhosis (26.7% vs. 5.0%, P < 0.01). Squamous cell carcinoma (SCC) of the oropharynx or esophagus and p osttransplant lymphoproliferative disorders were mainly observed. SCC (uvul a in two cases, tongue in one case, esophagus in one case, pharynx in one c ase) occurred exclusively in patients transplanted for alcoholic cirrhosis (16.7% vs. 0% P = 0.001). The incidence of posttransplant lymphoproliferati ve disorders was similar in alcoholics and nonalcoholics (6.7% vs. 5%, NS). Survival was not influenced by the occurrence of SCC. Conclusion. The incidence of oropharyngeal SCC could be high in patients re ceiving a transplant for alcoholic cirrhosis. This could be due to an addit ional effect of posttransplantation immunosuppression in patients exposed t o alcohol and tobacco before transplant. Careful posttransplantation screen ing of oropharyngeal SCC is warranted after liver transplantation for alcoh olic cirrhosis.