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Risk Factors of Aggressive Skin Cancer in Recipients of Solid Organ Transplants

By: Joseph Fanelli
Posted: Tuesday, January 15, 2019

Aggressive squamous cell carcinoma most commonly occurred on the face followed by the scalp and upper extremities in patients who received solid organ transplants, according to findings presented in JAMA Dermatology. The study, by Joana Lanz, MD, of the University Hospital Zurich, Switzerland, and colleagues sought to determine risk factors associated with aggressive squamous cell carcinoma in this patient population.

“Taken together, our case series confirms that anatomical site, differentiation, tumor diameter, tumor depth, and perineural invasion are important risk factors in aggressive squamous cell carcinoma in solid organ transplant recipients,” the authors concluded. “We also demonstrated a poor prognosis of aggressive squamous cell carcinoma.”

Their case series focused on 51 patients (43 men and 8 women) who had undergone solid organ transplantation and were diagnosed with aggressive squamous cell carcinoma. This type of skin cancer was defined by nodal or distant metastasis or death by local progression of primary squamous cell carcinoma. The median age at the time of transplant was 51 years, and the median age at the time of diagnosis of squamous cell carcinoma was 62 years.

Researchers found that squamous cell carcinoma most commonly localized on the face (67%), followed by the scalp (12%) and upper extremities (12%). A total of 21 tumors (41%) were poorly differentiated, with a medium diameter of 18 mm and a median tumor depth of 6.2 mm. Perineural tumor invasion was present in 20 patients (39%), with 23 (45%) experiencing local recurrence. The 5-year overall survival rate was 23%, with a 5-year disease-specific survival of 30.5%.

Disclosure: The study authors’ disclosure information can be found at jamanetwork.com



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