TY - JOUR
T1 - Validity of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) tool in a Dutch cohort of transplant recipients
AU - TransplantLines Investigators
AU - Bacoș-Cosma, Octavian I.
AU - Sidorenkov, Grigory A.
AU - Kremer, Daan
AU - Knobbe, Tim J.
AU - van der Vegt, Bert
AU - Bakker, Stephan J.L.
AU - Rácz, Emőke
AU - Annema, Coby
AU - Berger, Stefan P.
AU - Blokzijl, Hans
AU - Bodewes, Frank A.J.A.
AU - de Boer, Marieke T.
AU - Damman, Kevin
AU - de Borst, Martin H.
AU - Diepstra, Arjan
AU - Dijkstra, Gerard
AU - Doorenbos, Caecilia S.E.
AU - Douwes, Rianne M.
AU - Eisenga, Michele F.
AU - Erasmus, Michiel E.
AU - Gan, Tji C.
AU - Neto, Antonio W. Gomes
AU - Hak, Eelko
AU - Hepkema, Bouke G.
AU - Klont, Frank
AU - Leuvenink, Henri G.D.
AU - Lexmond, Willem S.
AU - de Meijer, Vincent E.
AU - Niesters, Hubert G.M.
AU - Nieuwenhuijs-Moeke, Gertrude J.
AU - van Pelt, Joost L.
AU - Pol, Robert A.
AU - Ranchor, Adelita V.
AU - Sanders, Jan Stephan F.
AU - Siebelink, Marion J.
AU - Slart, Riemer J.H.J.A.
AU - Swarte, Casper J.
AU - Touw, Daan J.
AU - van den Heuvel, Marius C.
AU - van Leer-Buter, Coretta
AU - van Londen, Marco
AU - Verschuuren, Erik A.M.
AU - Vos, Michel J.
AU - Weersma, Rinse K.
N1 - Publisher Copyright:
© 2024 The Author(s). JEADV Clinical Practice published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2025/3
Y1 - 2025/3
N2 - Background: To identify patients with high risk of skin cancer, risk prediction tools have been developed.Objectives: External validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a Dutch cohort of solid organ transplant recipients (SOTR) and exploration of the possibility of incorporating additional risk factors to enhance its predictive performance.Methods: We used data from the ongoing, prospective TransplantLines Biobank and Cohort Study of the University Medical Center Groningen (Groningen, The Netherlands). We conducted a survival analysis using Fine and Gray models to determine the subdistribution hazard ratios of the SUNTRAC risk factors and groups, Wolbers C index to assess its discriminative power, and cumulative incidences of skin cancer to assess its calibration. We applied the same methods for the incorporation of additional risk factors to the model.Results: A total of 2099 patients were included with a median age at transplantation of 52.1 years (Interquartile range [IQR]: 40.6–60.1) and a median follow-up time of 6.6 years (IQR: 3.4–12.5). In total 478 (22.8%) patients developed skin cancer. Basal cell carcinoma (53.3%) and cutaneous squamous cell carcinoma (42.9%) were most prevalent. The cumulative incidences of skin cancer per SUNTRAC risk group at 10 years were: low-risk (1.8%), medium-risk (12.9%), high-risk (34.3%) and very high-risk (68.6%). Significantly different skin cancer risk rates were observed for the medium-risk (SHR = 9.9, 95% CI: 2.51–39.4), high-risk (SHR = 21.5, 95% CI: 5.40–85.2) and very high-risk (SHR = 80.3, 95% CI: 19.26–335.1) groups in reference to the low-risk group. Wolbers C-index at 5 years was 0.71. The model was well calibrated for our cohort. The addition of other potential risk factors yielded no or marginal improvement of discriminative value on top of SUNTRAC.Conclusions: SUNTRAC is valid for the general Dutch SOTR population, and it can be clinically implemented.
AB - Background: To identify patients with high risk of skin cancer, risk prediction tools have been developed.Objectives: External validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a Dutch cohort of solid organ transplant recipients (SOTR) and exploration of the possibility of incorporating additional risk factors to enhance its predictive performance.Methods: We used data from the ongoing, prospective TransplantLines Biobank and Cohort Study of the University Medical Center Groningen (Groningen, The Netherlands). We conducted a survival analysis using Fine and Gray models to determine the subdistribution hazard ratios of the SUNTRAC risk factors and groups, Wolbers C index to assess its discriminative power, and cumulative incidences of skin cancer to assess its calibration. We applied the same methods for the incorporation of additional risk factors to the model.Results: A total of 2099 patients were included with a median age at transplantation of 52.1 years (Interquartile range [IQR]: 40.6–60.1) and a median follow-up time of 6.6 years (IQR: 3.4–12.5). In total 478 (22.8%) patients developed skin cancer. Basal cell carcinoma (53.3%) and cutaneous squamous cell carcinoma (42.9%) were most prevalent. The cumulative incidences of skin cancer per SUNTRAC risk group at 10 years were: low-risk (1.8%), medium-risk (12.9%), high-risk (34.3%) and very high-risk (68.6%). Significantly different skin cancer risk rates were observed for the medium-risk (SHR = 9.9, 95% CI: 2.51–39.4), high-risk (SHR = 21.5, 95% CI: 5.40–85.2) and very high-risk (SHR = 80.3, 95% CI: 19.26–335.1) groups in reference to the low-risk group. Wolbers C-index at 5 years was 0.71. The model was well calibrated for our cohort. The addition of other potential risk factors yielded no or marginal improvement of discriminative value on top of SUNTRAC.Conclusions: SUNTRAC is valid for the general Dutch SOTR population, and it can be clinically implemented.
KW - screening
KW - skin cancer
KW - solid organ transplant recipients
KW - SUNTRAC
UR - https://www.scopus.com/pages/publications/85211639738
U2 - 10.1002/jvc2.555
DO - 10.1002/jvc2.555
M3 - Article
SN - 2768-6566
VL - 4
SP - 117
EP - 127
JO - JEADV Clinical Practice
JF - JEADV Clinical Practice
IS - 1
ER -