Organ transplant recipients with cSCC face greater risks for recurrence, metastasis, death
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Key takeaways:
- Organ transplant recipients (OTRs) are 4.3 times more likely to develop a second carcinoma than non-organ transplant recipients.
- OTRs are 1.5 and 5.5 times more likely to experience metastasis and death.
Organ transplant recipients diagnosed with cutaneous squamous cell carcinoma are more likely to experience recurrence, metastasis and death from this cancer compared with non-organ transplant recipients, according to a study.
“Organ transplant recipients (OTRs) have a very high risk of developing [cutaneous squamous cell carcinoma (cSCC)] and seem to have a greater risk of metastasis from cSCC than immunocompetent patients,” Petter Gjersvik, MD, PhD, of the department of dermatology at Oslo University Hospital in Oslo, Norway, and colleagues wrote. “Studies on the risk of disease-specific death from cSCC, however, are limited both in immunocompetent and immunosuppressed patients.”
Organ transplant recipients diagnosed with cutaneous squamous cell carcinoma are more likely to experience recurrence, metastasis and death. Image: Adobe Stock.
In this population-based study, Gjersvik and colleagues investigated the rates of second cSCC, metastasis and death from cSCC in OTRs and non-OTRs. The researchers used the Cancer Registry of Norway to compile data on 1,208 OTRs (median age at first diagnosis, 66 years; 73% men) and 46,784 non-OTRs (median age at first diagnosis, 79 years; 54.3% men) with cSCC from 1968 to 2020.
The rate of a second cSCC per 1,000 person-years was much higher in OTRs (250.6; 95% CI, 232.2-270.1) compared with non-OTRs (30.9; 95% CI, 30.2-31.6), with OTRs having a 4.3-fold increased rate of developing a second cSCC.
The rate of metastasis per 1,000 person-years was nearly twice as high in the OTR group (4.8; 95% CI, 3.4-6.7) compared with the non-OTR group (2.8; 95% CI, 2.6-3.0).
The majority of deaths across all groups were not caused by cSCC (98.2%); however, death from cSCC occurred more frequently in OTRs (3.3%) than non-OTRS (1.1%). That makes the rate of death from cSCC per 1,000 person-years to be 1.7 (95% CI, 1.5-1.8) in non-OTRs and 5.4 (95% CI, 3.9-7.4) in OTRs, or a 5.5-fold increase of death among OTRs.
According to Gjersvik and colleagues, OTRs are particularly burdened by cSCC. Furthermore, current tools and practices do not allow for efficient diagnosis, treatment and follow-up of cSCC in this population, according to the researchers.
“With the high volume of patients with cSCC, skin cancer services should be organized so that patients receive individualized and optimal care without an unmanageably high number of consultations and referrals,” Gjersvik and colleagues concluded.