Nonmelanoma skin cancer after renal transplantation: a single-center experience in 1736 transplantations.

Abstract

BACKGROUND:

Renal transplantation is associated with an increased incidence of nonmela-noma skin cancer (NMSC) caused by immunosuppression. Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), the two major histological types of NMSC, exhibit more aggressive biological and clinical courses in renal transplant recipients (RTRs), with higher rates of recurrence and mortality than in the general population.

METHODS:

We retrospectively analyzed our experience of NMSC in 1736 renal transplantations performed over a 25-year period. All cases of skin cancer after renal transplantation were included except those of skin cancer resulting from melanoma and mesenchymal skin tumors.

RESULTS:

In our series, the overall incidence of NMSC after transplantation was 2.2% (n = 39), and SCC represented the most frequent skin malignancy (64.1%), followed by BCC (17.9%), Bowen's disease (10.2%), basosquamous carcinoma (5.1%), and a rare case of invasive sebaceous carcinoma (2.6%). A shift to newer immunosuppressive regimens after the initial diagnosis of NMSC had been implemented in eight cases (20.5%). The recurrence rate after initial treatment was 41% (n = 16), and distant metastatic disease was diagnosed in 15.4% (n = 6) of NMSC patients. The NMSC-specific mortality rate was 25.6% (n = 10).

CONCLUSIONS:

Nonmelanoma skin cancer remains a significant source of morbidity and mortality in RTRs, and post-transplant surveillance should be increased.

• Authors: George Zavos, Nikolaos P Karidis, Gerasimos Tsourouflis, John Bokos, Konstantinos Diles, George Sotirchos, Eleni Theodoropoulou, Alkiviadis Kostakis
• Journal: International journal of dermatology (Int J Dermatol) Vol. 50 Issue 12 Pg. 1496-500 (Dec 2011) ISSN: 1365-4632 [Electronic] England
• PMID: 21790552 (Publication Type: Journal Article)
• Copyright: © 2011 The International Society of Dermatology.

Chemical References

• Immunosuppressive Agents

Topics

• Adenocarcinoma, Sebaceous (epidemiology, etiology)
• Adult
• Aged
• Carcinoma, Basal Cell (epidemiology, etiology)
• Carcinoma, Squamous Cell (epidemiology, etiology)
• Female
• Humans
• Immunosuppression Therapy (adverse effects)
• Immunosuppressive Agents (adverse effects)
• Incidence
• Kidney Transplantation (adverse effects)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, etiology)
• Retrospective Studies
• Sebaceous Gland Neoplasms (epidemiology, etiology)
• Skin Neoplasms (epidemiology, etiology)
• Young Adult