Head and neck cancer in transplant recipients

Abstract

Objectives/hypothesis: The development of malignancy in organ transplant patients is a well-known complication of long-term immunosuppressive therapy. We sought to characterize our institution's 20-year experience with head and neck cancer after solid organ transplantation.

Study design: Retrospective review.

Methods: Patients who underwent a solid organ transplant with subsequent development of a head and neck malignancy, including cutaneous and noncutaneous (upper aerodigestive tract and salivary gland) cancers, from January 1990 through December 2011 were identified. Patients were stratified according to cancer type, location, stage, and survival and compared to a nontransplant cohort in our institution's tumor registry.

Results: Of 95 patients identified, 17 had noncutaneous and 78 had cutaneous head and neck malignancies post-transplant. Among the noncutaneous group, no statistically significant differences occurred in age, gender, stage, or 5-year survival status when compared to the nontransplant tumor registry cohort. However, significantly fewer transplant patients were alive at 1 year. Among the cutaneous group, >50% had multiple malignancies. The total incidence of head and neck cancer following organ transplantation was 2.6%.

Conclusions: Although the development of head and neck cancer is a rare side effect of immunosuppression, it still warrants attention. These patients have been found to be less likely to survive >1 year when compared to their nontransplant counterparts. Patients who develop head and neck malignancies following organ transplantation require aggressive screening, treatment, and follow-up, as this diagnosis may portend a poor prognosis.