TY - JOUR
T1 - Aggressive behavior of nonmelanotic skin cancers in solid organ transplant recipients
AU - Lott, David G.
AU - Manz, Ryan
AU - Koch, Carl
AU - Lorenz, Robert R.
PY - 2010/9/27
Y1 - 2010/9/27
N2 - Background. The increased incidence of skin cancers in solid organ transplant recipients (OTR) has been well established. However, our understanding of the potential aggressive behavior of these cancers has been largely based on the findings of multiple different studies analyzing isolated indicators of aggressive behavior. The purpose of this study was to determine the aggressiveness of nonmelanotic skin cancers in a large transplant population compared with an immunocompetent control population with similar cancers. Methods. Immunosuppressed transplanted patients and an immunocompetent control group matched in size with squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) were evaluated for the factors of aggressiveness. A retrospective chart review was performed. Data obtained included transplant type, number of cancers, local recurrence rate, lymph node involvement, lymphatic invasion, perineural invasion, deep spread, subsequent treatment with radiation or chemotherapy, and death from disease. Results. Three hundred seven patients had SCC (OTR: 153, control: 154), and 246 patients had BCC (OTR: 123, control: 123). SCC in OTR was significantly more likely to have an increased number of primary tumors, deep tissue spread, perineural and lymphatic invasion, recurrence, and need for radiation or chemotherapy. BCC in OTR was not associated with more aggressive disease when compared with controls with BCC. Conclusions. SCC in OTR behaves significantly more aggressively than in immunocompetent patients. BCC in the OTR population does not seem to act more aggressively.
AB - Background. The increased incidence of skin cancers in solid organ transplant recipients (OTR) has been well established. However, our understanding of the potential aggressive behavior of these cancers has been largely based on the findings of multiple different studies analyzing isolated indicators of aggressive behavior. The purpose of this study was to determine the aggressiveness of nonmelanotic skin cancers in a large transplant population compared with an immunocompetent control population with similar cancers. Methods. Immunosuppressed transplanted patients and an immunocompetent control group matched in size with squamous cell carcinoma (SCC) or basal cell carcinoma (BCC) were evaluated for the factors of aggressiveness. A retrospective chart review was performed. Data obtained included transplant type, number of cancers, local recurrence rate, lymph node involvement, lymphatic invasion, perineural invasion, deep spread, subsequent treatment with radiation or chemotherapy, and death from disease. Results. Three hundred seven patients had SCC (OTR: 153, control: 154), and 246 patients had BCC (OTR: 123, control: 123). SCC in OTR was significantly more likely to have an increased number of primary tumors, deep tissue spread, perineural and lymphatic invasion, recurrence, and need for radiation or chemotherapy. BCC in OTR was not associated with more aggressive disease when compared with controls with BCC. Conclusions. SCC in OTR behaves significantly more aggressively than in immunocompetent patients. BCC in the OTR population does not seem to act more aggressively.
KW - Basal cell cancer
KW - Immunosuppression
KW - Skin cancer
KW - Squamous cell cancer
KW - Transplant
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UR - http://www.scopus.com/inward/citedby.url?scp=77957262713&partnerID=8YFLogxK
U2 - 10.1097/TP.0b013e3181ec7228
DO - 10.1097/TP.0b013e3181ec7228
M3 - Article
C2 - 20808266
AN - SCOPUS:77957262713
SN - 0041-1337
VL - 90
SP - 683
EP - 687
JO - Transplantation
JF - Transplantation
IS - 6
ER -