TY - JOUR
T1 - Cumulative incidence and risk factors for cutaneous squamous cell carcinoma metastases in organ transplant recipients
T2 - The Skin Care in Organ Transplant Patients in Europe-International Transplant Skin Cancer Collaborative metastases study, a prospective multicenter study
AU - de Jong, Estella
AU - Genders, Roel
AU - Harwood, Catherine A.
AU - Green, Adèle C.
AU - Plasmeijer, Elsemieke I.
AU - Proby, Charlotte
AU - Geissler, Edward
AU - Ferrándiz-Pulido, Carla
AU - Ducroux, Emilie
AU - Euvrard, Sylvie
AU - Geusau, Alexandra
AU - Jahn-Bassler, Karin
AU - Borik-Heil, Liliane
AU - Rácz, Emõke
AU - Nägeli, Mirjam
AU - Hofbauer, Günther F.L.
AU - Piaserico, Stefano
AU - Russo, Irene
AU - Mackintosh, Lorna
AU - Borges-Costa, João
AU - Angeliki-Gkini, Maria
AU - Zavattaro, Elisa
AU - Savoia, Paola
AU - Imko-Walszuk, Beata
AU - Dębska-Slizień, Alicja
AU - Garmyn, Marjan
AU - van Kelst, Sofie
AU - Ricar, Jan
AU - Cetkovska, Petra
AU - Matin, Rubeta
AU - Güleç, Ayşe Tülin
AU - Seçkin, Deniz
AU - Anene, Chinedu Anthony
AU - Oliveira, Walmar R.P.
AU - Rademaker, Marius
AU - Goeman, Jelle
AU - van Geloven, Nan
AU - Ruiz, Emily
AU - Murad, Fadi
AU - Karn, Emily
AU - Schmults, Chrysalyne D.
AU - Bouwes Bavinck, Jan Nico
N1 - Publisher Copyright:
© 2024
PY - 2024/6
Y1 - 2024/6
N2 - Introduction: Solid organ transplant recipients (SOTRs) are believed to have an increased risk of metastatic cutaneous squamous cell carcinoma (cSCC), but reliable data are lacking regarding the precise incidence and associated risk factors. Methods: In a prospective cohort study, including 19 specialist dermatology outpatient clinics in 15 countries, patient and tumor characteristics were collected using standardized questionnaires when SOTRs presented with a new cSCC. After a minimum of 2 years of follow-up, relevant data for all SOTRs were collected. Cumulative incidence of metastases was calculated by the Aalen-Johansen estimator. Fine and Gray models were used to assess multiple risk factors for metastases. Results: Of 514 SOTRs who presented with 623 primary cSCCs, metastases developed in 37 with a 2-year patient-based cumulative incidence of 6.2%. Risk factors for metastases included location in the head and neck area, local recurrence, size > 2 cm, clinical ulceration, poor differentiation grade, perineural invasion, and deep invasion. A high-stage tumor that is also ulcerated showed the highest risk of metastasis, with a 2-year cumulative incidence of 46.2% (31.9%-68.4%). Conclusions: SOTRs have a high risk of cSCC metastases and well-established clinical and histologic risk factors have been confirmed. High-stage, ulcerated cSCCs have the highest risk of metastasis.
AB - Introduction: Solid organ transplant recipients (SOTRs) are believed to have an increased risk of metastatic cutaneous squamous cell carcinoma (cSCC), but reliable data are lacking regarding the precise incidence and associated risk factors. Methods: In a prospective cohort study, including 19 specialist dermatology outpatient clinics in 15 countries, patient and tumor characteristics were collected using standardized questionnaires when SOTRs presented with a new cSCC. After a minimum of 2 years of follow-up, relevant data for all SOTRs were collected. Cumulative incidence of metastases was calculated by the Aalen-Johansen estimator. Fine and Gray models were used to assess multiple risk factors for metastases. Results: Of 514 SOTRs who presented with 623 primary cSCCs, metastases developed in 37 with a 2-year patient-based cumulative incidence of 6.2%. Risk factors for metastases included location in the head and neck area, local recurrence, size > 2 cm, clinical ulceration, poor differentiation grade, perineural invasion, and deep invasion. A high-stage tumor that is also ulcerated showed the highest risk of metastasis, with a 2-year cumulative incidence of 46.2% (31.9%-68.4%). Conclusions: SOTRs have a high risk of cSCC metastases and well-established clinical and histologic risk factors have been confirmed. High-stage, ulcerated cSCCs have the highest risk of metastasis.
KW - immunosuppression
KW - organ transplantation
KW - skin cancer
KW - squamous cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85186178551&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2024.01.040
DO - 10.1016/j.jaad.2024.01.040
M3 - Article
C2 - 38301923
AN - SCOPUS:85186178551
SN - 0190-9622
VL - 90
SP - 1200
EP - 1209
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 6
ER -