Second primary cancer after liver transplantation in hepatocellular carcinoma: a nationwide population-based study.

PURPOSE: The aim of this study is to evaluate prevalence of second primary cancer (SPC) among hepatocellular carcinoma (HCC) patients after liver transplantation (LT) by using nationwide claims data from South Korea. MATERIALS AND METHODS: The nationwide cohort included patients who were diagnosed with HCC and received LT from 1 January 2010 to 31 December 2014. We analyzed frequency and standardized incidence ratios (SIRs) to estimate the risk of SPC in HCC patients after LT. RESULTS: A total of 2462 patients who were diagnosed with HCC and received LT were confirmed. Of these patients, 103 (4.2%) developed SPC after LT; the most common cancer site was lung (16.5%). Patients with HCC receiving LT had high risk of SPC [SIR 2.79, 95% confidence interval (CI) 2.27-3.38], particularly lymphoma (SIR 9.26), myeloma (SIR 10.60), and bladder cancer (SIR 7.19). The 12-, 24-, 36-, and 48-month overall survival for patients with HCC after LT was 92.7, 87.8, 84.6, and 82.1%, respectively. CONCLUSIONS: HCC patients with LT had longer life expectancy and higher risk for SPC compared with the general population. Therefore, close surveillance for SPC is important in patients with HCC receiving LT.