Long-Term Outcomes in Surgically Managed Skin Cancer in Transplant Recipients
Posted: Monday, August 24, 2020
For immunosuppressed recipients of cardiac and liver transplants, T3 and T4 non-melanoma skin cancers seem to be associated with a higher incidence of recurrence as compared with early-stage tumors, according to a study published in the American Journal of Clinical Oncology. “This is the first study describing the American Joint Committee on Cancer 8th edition stage-based patterns of recurrence and long-term outcomes of surgically managed non-melanoma skin cancer in a large cohort of immunosuppressed cardiac and liver transplant recipients,” reported Samir H. Patel, MD, of the Mayo Clinic, and colleagues. Further analysis is warranted to isolate risk factors related to recurrence, which should guide treatment decisions for this high-risk population.
From 1986 to 2013, a total of 747 immunosuppressed recipients of cardiac (n = 138) and liver (n = 609) transplants were enrolled in the study. Patients were recruited from the Mayo Clinic. All patients had a history of invasive non-melanoma skin cancer following transplantation. The characteristics of patients and their tumors were assessed.
The investigators reported that 13% of patients developed 382 invasive non-melanoma skin cancers. At a 10-year assessment, there was a 20% local recurrence rate, with 14% of patients demonstrating multiple local recurrences. Moreover, the comparison between T3 or T4 tumors and T1 or T2 tumors revealed increased local recurrence rates for T3 or T4 tumors (32.5% vs. 20%, respectively). The study authors also identified a 79% overall survival rate at a 10-year follow-up. Patients older than age 61 had decreased overall survival compared with the study population (P < 0.01).
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