Malignant melanoma in solid transplant recipients: Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis

Jerry D. Brewer, Leslie J. Christenson, Amy L. Weaver, Daniel C. Dapprich, Roger H. Weenig, Katherine K. Lim, John S. Walsh, Clark C. Otley, Wida Cherikh, Joseph F. Buell, E. Steve Woodle, Christopher Arpey, Pamela R. Patton

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective: To determine malignant melanoma cause-specific and overall survival among patients with melanoma diagnosed after organ transplantation compared with a national sample with malignant melanoma. Design: Retrospective review. Setting: Mayo Clinic sites. Patients: Immunosuppressed organ transplant recipients with malignant melanoma identified from surgical and medical databases at Mayo Clinic (1978-2007), the Organ Procurement and Transplantation Network/United Network for Organ Sharing database (1999-2006), and the Israel Penn International Transplant Tumor Registry (1967-2007). Main Outcome Measures: Prognostic analyses by Breslow thickness and Clark level of overall and melanoma cause-specific survival. Expected survival rates were estimated by applying the age-, sex-, and calendar year-specific survival rates of patients with malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program to the study cohort. Results: Malignant melanoma was diagnosed in 638 patients (724 cases) after transplantation. Breslow thickness was available for 123 patients; Clark level, for 175. Three-year overall survival rates for patients stratified by Breslow thickness (≤0.75, 0.76-1.50, 1.51-3.00, and >3.00 mm) were 88.2%, 80.8%, 51.2%, and 55.3%, respectively, and 3-year cause-specific survival rates (95% confidence intervals) were 97.8% (93.7%-100%), 89.4% (76.5%-100%), 73.2% (53.2%-100%), and 73.9% (56.4%-96.6%), respectively. Three-year cause-specific survival rates (95% confidence intervals) for patients stratified by Clark level (I-IV) were 100%, 97.4% (92.4%-100%), 82.8% (65.3%-100%), and 65.8% (51.8%-83.7%), respectively. For patients with Breslow thickness of 1.51 to 3.00 mm and Clark level III or IV, the cause-specific survival rate in the study sample was significantly different from the expected estimates for patients with the same Breslow thickness or Clark level. Conclusions: Compared with the expected survival rates derived from malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program, immunosuppressed organ transplant recipients with thicker melanomas (ie, with a Clark level of III or IV or a Breslow thickness of 1.51 to 3.00 mm) had a significantly poorer malignant melanoma cause-specific survival rate. The overall survival rate was worse among patients with a prior history of transplantation, regardless of Breslow thickness or Clark level.

Original languageEnglish (US)
Pages (from-to)790-796
Number of pages7
JournalArchives of Dermatology
Volume147
Issue number7
StatePublished - Jul 2011

Fingerprint

Melanoma
Epidemiology
Databases
Survival Rate
SEER Program
Organ Transplantation
Transplants
Transplantation
Transplant Recipients
Confidence Intervals
Tissue and Organ Procurement
Survival
Israel
Registries
Cohort Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

Cite this

Brewer, J. D., Christenson, L. J., Weaver, A. L., Dapprich, D. C., Weenig, R. H., Lim, K. K., ... Patton, P. R. (2011). Malignant melanoma in solid transplant recipients: Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis. Archives of Dermatology, 147(7), 790-796.

Malignant melanoma in solid transplant recipients : Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis. / Brewer, Jerry D.; Christenson, Leslie J.; Weaver, Amy L.; Dapprich, Daniel C.; Weenig, Roger H.; Lim, Katherine K.; Walsh, John S.; Otley, Clark C.; Cherikh, Wida; Buell, Joseph F.; Woodle, E. Steve; Arpey, Christopher; Patton, Pamela R.

In: Archives of Dermatology, Vol. 147, No. 7, 07.2011, p. 790-796.

Research output: Contribution to journalArticle

Brewer, JD, Christenson, LJ, Weaver, AL, Dapprich, DC, Weenig, RH, Lim, KK, Walsh, JS, Otley, CC, Cherikh, W, Buell, JF, Woodle, ES, Arpey, C & Patton, PR 2011, 'Malignant melanoma in solid transplant recipients: Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis', Archives of Dermatology, vol. 147, no. 7, pp. 790-796.
Brewer, Jerry D. ; Christenson, Leslie J. ; Weaver, Amy L. ; Dapprich, Daniel C. ; Weenig, Roger H. ; Lim, Katherine K. ; Walsh, John S. ; Otley, Clark C. ; Cherikh, Wida ; Buell, Joseph F. ; Woodle, E. Steve ; Arpey, Christopher ; Patton, Pamela R. / Malignant melanoma in solid transplant recipients : Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis. In: Archives of Dermatology. 2011 ; Vol. 147, No. 7. pp. 790-796.
@article{6c3bb36968f947a48a90255e950c126a,
title = "Malignant melanoma in solid transplant recipients: Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis",
abstract = "Objective: To determine malignant melanoma cause-specific and overall survival among patients with melanoma diagnosed after organ transplantation compared with a national sample with malignant melanoma. Design: Retrospective review. Setting: Mayo Clinic sites. Patients: Immunosuppressed organ transplant recipients with malignant melanoma identified from surgical and medical databases at Mayo Clinic (1978-2007), the Organ Procurement and Transplantation Network/United Network for Organ Sharing database (1999-2006), and the Israel Penn International Transplant Tumor Registry (1967-2007). Main Outcome Measures: Prognostic analyses by Breslow thickness and Clark level of overall and melanoma cause-specific survival. Expected survival rates were estimated by applying the age-, sex-, and calendar year-specific survival rates of patients with malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program to the study cohort. Results: Malignant melanoma was diagnosed in 638 patients (724 cases) after transplantation. Breslow thickness was available for 123 patients; Clark level, for 175. Three-year overall survival rates for patients stratified by Breslow thickness (≤0.75, 0.76-1.50, 1.51-3.00, and >3.00 mm) were 88.2{\%}, 80.8{\%}, 51.2{\%}, and 55.3{\%}, respectively, and 3-year cause-specific survival rates (95{\%} confidence intervals) were 97.8{\%} (93.7{\%}-100{\%}), 89.4{\%} (76.5{\%}-100{\%}), 73.2{\%} (53.2{\%}-100{\%}), and 73.9{\%} (56.4{\%}-96.6{\%}), respectively. Three-year cause-specific survival rates (95{\%} confidence intervals) for patients stratified by Clark level (I-IV) were 100{\%}, 97.4{\%} (92.4{\%}-100{\%}), 82.8{\%} (65.3{\%}-100{\%}), and 65.8{\%} (51.8{\%}-83.7{\%}), respectively. For patients with Breslow thickness of 1.51 to 3.00 mm and Clark level III or IV, the cause-specific survival rate in the study sample was significantly different from the expected estimates for patients with the same Breslow thickness or Clark level. Conclusions: Compared with the expected survival rates derived from malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program, immunosuppressed organ transplant recipients with thicker melanomas (ie, with a Clark level of III or IV or a Breslow thickness of 1.51 to 3.00 mm) had a significantly poorer malignant melanoma cause-specific survival rate. The overall survival rate was worse among patients with a prior history of transplantation, regardless of Breslow thickness or Clark level.",
author = "Brewer, {Jerry D.} and Christenson, {Leslie J.} and Weaver, {Amy L.} and Dapprich, {Daniel C.} and Weenig, {Roger H.} and Lim, {Katherine K.} and Walsh, {John S.} and Otley, {Clark C.} and Wida Cherikh and Buell, {Joseph F.} and Woodle, {E. Steve} and Christopher Arpey and Patton, {Pamela R.}",
year = "2011",
month = "7",
language = "English (US)",
volume = "147",
pages = "790--796",
journal = "JAMA Dermatology",
issn = "2168-6068",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Malignant melanoma in solid transplant recipients

T2 - Collection of database cases and comparison with surveillance, epidemiology, and end results data for outcome analysis

AU - Brewer, Jerry D.

AU - Christenson, Leslie J.

AU - Weaver, Amy L.

AU - Dapprich, Daniel C.

AU - Weenig, Roger H.

AU - Lim, Katherine K.

AU - Walsh, John S.

AU - Otley, Clark C.

AU - Cherikh, Wida

AU - Buell, Joseph F.

AU - Woodle, E. Steve

AU - Arpey, Christopher

AU - Patton, Pamela R.

PY - 2011/7

Y1 - 2011/7

N2 - Objective: To determine malignant melanoma cause-specific and overall survival among patients with melanoma diagnosed after organ transplantation compared with a national sample with malignant melanoma. Design: Retrospective review. Setting: Mayo Clinic sites. Patients: Immunosuppressed organ transplant recipients with malignant melanoma identified from surgical and medical databases at Mayo Clinic (1978-2007), the Organ Procurement and Transplantation Network/United Network for Organ Sharing database (1999-2006), and the Israel Penn International Transplant Tumor Registry (1967-2007). Main Outcome Measures: Prognostic analyses by Breslow thickness and Clark level of overall and melanoma cause-specific survival. Expected survival rates were estimated by applying the age-, sex-, and calendar year-specific survival rates of patients with malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program to the study cohort. Results: Malignant melanoma was diagnosed in 638 patients (724 cases) after transplantation. Breslow thickness was available for 123 patients; Clark level, for 175. Three-year overall survival rates for patients stratified by Breslow thickness (≤0.75, 0.76-1.50, 1.51-3.00, and >3.00 mm) were 88.2%, 80.8%, 51.2%, and 55.3%, respectively, and 3-year cause-specific survival rates (95% confidence intervals) were 97.8% (93.7%-100%), 89.4% (76.5%-100%), 73.2% (53.2%-100%), and 73.9% (56.4%-96.6%), respectively. Three-year cause-specific survival rates (95% confidence intervals) for patients stratified by Clark level (I-IV) were 100%, 97.4% (92.4%-100%), 82.8% (65.3%-100%), and 65.8% (51.8%-83.7%), respectively. For patients with Breslow thickness of 1.51 to 3.00 mm and Clark level III or IV, the cause-specific survival rate in the study sample was significantly different from the expected estimates for patients with the same Breslow thickness or Clark level. Conclusions: Compared with the expected survival rates derived from malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program, immunosuppressed organ transplant recipients with thicker melanomas (ie, with a Clark level of III or IV or a Breslow thickness of 1.51 to 3.00 mm) had a significantly poorer malignant melanoma cause-specific survival rate. The overall survival rate was worse among patients with a prior history of transplantation, regardless of Breslow thickness or Clark level.

AB - Objective: To determine malignant melanoma cause-specific and overall survival among patients with melanoma diagnosed after organ transplantation compared with a national sample with malignant melanoma. Design: Retrospective review. Setting: Mayo Clinic sites. Patients: Immunosuppressed organ transplant recipients with malignant melanoma identified from surgical and medical databases at Mayo Clinic (1978-2007), the Organ Procurement and Transplantation Network/United Network for Organ Sharing database (1999-2006), and the Israel Penn International Transplant Tumor Registry (1967-2007). Main Outcome Measures: Prognostic analyses by Breslow thickness and Clark level of overall and melanoma cause-specific survival. Expected survival rates were estimated by applying the age-, sex-, and calendar year-specific survival rates of patients with malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program to the study cohort. Results: Malignant melanoma was diagnosed in 638 patients (724 cases) after transplantation. Breslow thickness was available for 123 patients; Clark level, for 175. Three-year overall survival rates for patients stratified by Breslow thickness (≤0.75, 0.76-1.50, 1.51-3.00, and >3.00 mm) were 88.2%, 80.8%, 51.2%, and 55.3%, respectively, and 3-year cause-specific survival rates (95% confidence intervals) were 97.8% (93.7%-100%), 89.4% (76.5%-100%), 73.2% (53.2%-100%), and 73.9% (56.4%-96.6%), respectively. Three-year cause-specific survival rates (95% confidence intervals) for patients stratified by Clark level (I-IV) were 100%, 97.4% (92.4%-100%), 82.8% (65.3%-100%), and 65.8% (51.8%-83.7%), respectively. For patients with Breslow thickness of 1.51 to 3.00 mm and Clark level III or IV, the cause-specific survival rate in the study sample was significantly different from the expected estimates for patients with the same Breslow thickness or Clark level. Conclusions: Compared with the expected survival rates derived from malignant melanoma cases reported in the Surveillance, Epidemiology, and End Results Program, immunosuppressed organ transplant recipients with thicker melanomas (ie, with a Clark level of III or IV or a Breslow thickness of 1.51 to 3.00 mm) had a significantly poorer malignant melanoma cause-specific survival rate. The overall survival rate was worse among patients with a prior history of transplantation, regardless of Breslow thickness or Clark level.

UR - http://www.scopus.com/inward/record.url?scp=79960611278&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79960611278&partnerID=8YFLogxK

M3 - Article

C2 - 21768478

AN - SCOPUS:79960611278

VL - 147

SP - 790

EP - 796

JO - JAMA Dermatology

JF - JAMA Dermatology

SN - 2168-6068

IS - 7

ER -