Does Squamous Cell Carcinoma Risk Change With Immunosuppression?
Posted: Tuesday, April 23, 2019
Immunosuppressed patients seem to have an increased risk of poor outcomes with multiple squamous cell carcinomas compared with those who are immunocompetent. Jessica L. Gonzalez, MD, of Tufts Medical Center in Boston, and colleagues published the results of a single center case-control study in a research letter in JAMA Dermatology.
“The findings support the clinical practice of vigilant screening and aggressive treatment for immunosuppressed patients with multiple [squamous cell carcinomas],” concluded the authors.
Patients with primary invasive squamous cell carcinomas being treated at Tufts Medical Center from 2005 to 2015 were included in the study. There was a total of 106 immunosuppressed patients included in the study who were matched by race, sex, and age to immunocompetent patients at a ratio of 1:2. Common causes of immunosuppression were organ transplantation and inflammatory disease. Those who were immunocompromised were more likely to have multiple tumors compared with immunocompetent patients (57% vs. 25%, respectively).
For patients who were immunocompromised, those with 2 to 9 tumors had a 30% increased risk of local recurrence and those with 10 or more tumors had a 69% increased risk. Those with only 1 tumor had a 4% increased risk of recurrence. A similar trend was seen for disease-specific outcomes, where 32% of those with 2 to 9 tumors and 69% of those with more than 10 tumors had poor outcomes. When comparing immunocompromised and immunocompetent patients, the odds of having a local recurrence or poor disease-specific outcome increased by 10- to 11-fold for those with between 2 and 9 tumors.
Disclosure: The study authors reported no conflicts of interest.