The implications of a lung malignancy in a lung transplant recipient are poorly understood. Here, we linked national transplant and cancer databases to determine how lung cancer impacted prognosis in lung transplant recipients with incidentally explanted lung cancers (IELCs). Records from the Scientific Registry of Transplant Recipients and National Cancer Database were linked to identify 186 patients who received a lung transplant and were subsequently diagnosed with lung cancer. These patients were determined to have IELC and were compared with control patients who received a lung transplant but were not diagnosed with IELC. Of the 186 patients, 144 had non-small cell lung cancer (NSCLC), 6 had small cell lung cancer, and 36 had neuroendocrine cancer. Patients with stage I/II NSCLC or any stage neuroendocrine cancer had overall survival and cancer-related mortality rates comparable with those of controls. Conversely, patients with stage III/IV NSCLC had worse overall survival, higher rates of cancer-related mortality, and infrequently received cancer-specific nonoperative treatment. Taken together, stage I/II NSCLC and neuroendocrine cancers should be reconsidered as an absolute contraindication to transplant. Conversely, patients with stage III/IV NSCLC had worse outcomes, and strategies are needed to increase the use of adjuvant therapy.

中文翻译：

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外植体偶然发现的肺癌的预后意义：移植受者科学登记处和美国国家癌症数据库的联合研究


肺移植受者肺恶性肿瘤的影响知之甚少。在这里，我们链接了国家移植和癌症数据库，以确定肺癌如何影响意外外植肺癌 （IELC） 肺移植受者的预后。来自移植受者科学登记处和国家癌症数据库的记录被链接起来，以确定 186 名接受肺移植并随后被诊断出患有肺癌的患者。这些患者被确定患有 IELC，并与接受肺移植但未诊断为 IELC 的对照患者进行比较。在 186 例患者中，144 例为非小细胞肺癌 （NSCLC），6 例为小细胞肺癌，36 例为神经内分泌癌。I/II 期 NSCLC 或任何阶段神经内分泌癌患者的总生存期和癌症相关死亡率与对照组相当。相反，III/IV 期 NSCLC 患者的总生存期较差，癌症相关死亡率较高，并且很少接受癌症特异性非手术治疗。综上所述，I/II 期 NSCLC 和神经内分泌癌应重新考虑作为移植的绝对禁忌证。相反，III/IV 期 NSCLC 患者的预后较差，需要策略增加辅助治疗的使用。