Organ Transplantation and Degree of Differentiation of Cutaneous Squamous Cell Carcinoma
Posted: Wednesday, January 2, 2019
To investigate whether cutaneous squamous cell carcinoma is more likely to be poorly differentiated in organ transplant recipients (OTRs) compared with non-OTRs, a team led by John Paoli, MD, of Sahlgrenska University Hospital, Gothenburg, Sweden, utilized more than a decade’s worth of crosschecked data on almost 1,000 patients. Poorly differentiated cutaneous squamous cell carcinomas tend to grow more quickly and metastasize more often than well-differentiated cutaneous squamous cell carcinomas.
Their results, published in Dermatology Practical & Conceptual, indicated that with a P value of .4, “OTRs do not develop a higher proportion of poorly differentiated [cutaneous squamous cell carcinomas] than non-OTRs,” the investigators wrote, although OTRs developed almost 5 times as many tumors. “The fact that OTRs acquire their tumors at a much younger age (20 years earlier than the non-OTRs) may explain [why] OTRs have a relatively small proportion of poorly and moderately differentiated tumors.”
When cutaneous squamous cell carcinoma occurred in either group of patients, the carcinomas were more often poorly differentiated if the patient was older than the median diagnosis age (OTRs: 59 years for women, 61 years for men; non-OTRs, 79 years for women, 81 years for men). The OTR group included 82 patients diagnosed between 2002 and 2015 with 515 cutaneous squamous cell carcinomas, basosquamous carcinomas, and/or cutaneous squamous cell carcinoma in situ tumors, compared with 883 non-OTR patients with 1,247 tumors of the same types.
Immunosuppression in OTRs leads to a well-documented increased risk of cancer, most frequently nonmelanoma skin cancer, especially cutaneous squamous cell carcinoma. Their risk of cutaneous squamous cell carcinoma, the authors noted, is 60 to 100 times greater than that of the general population.
Disclosure: The study authors reported no conflicts of interest.