Risk High, Prognosis Poor for Aggressive Squamous Cell Carcinoma in Organ Transplant Recipients
Poor histologic differentiation, local recurrence, perineural invasion common in organ transplant recipients with aggressive SCC.
Squamous cell carcinoma (SCC) occurs more frequently among organ transplant recipients than in the general population, therefore, researchers explored features of this relationship with results published in JAMA Dermatology.
According to the authors, SCC occurs 65- to 250-fold more often among recipients of solid organ transplants than among people who do not receive these transplants, affecting 20% to 75% of recipients within the first 2 decades posttransplant.
In this retrospective study, records from within the Skin Care in Organ Transplant Patients, Europe Network, were evaluated for 51 patients with a history of both solid organ transplantation and aggressive SCC.
Transplantation occurred at a median age of 51 years (range, 19 to 71 years), and aggressive SCC was diagnosed at a median age of 62 years (range, 36 to 77 years). Forty-three patients were men.
The face was the most common site of aggressive SCC (67%), with the scalp and upper extremities each representing 12% of cases. Poor histologic differentiation characterized 41% of tumors, local recurrence was experienced by 45% of patients, and perineural invasion occurred in 39% of patients. Tumors had a median diameter of 18.0 mm (range, 4.0 to 64.0 mm) and depth of 6.2 mm (range, 1.0 to 20.0 mm).
Mean overall survival at 5 years was 23.0% (SD, 6.4%), and at 10 years was 11.3% (SD, 5.5%). Disease-specific survival rates were 30.5% (SD, 7.6%) and 25.9% (SD, 7.1%), respectively.
Aggressive SCC in solid organ transplant recipients frequently carries a poor prognosis; therefore, posttransplant follow-up should include monitoring for risk factors such as poor differentiation and perineural invasion, as well as anatomical location and tumor size in this patient population.
Lanz J, Bouwes Bavinck JN, Westhuis M, et al. Aggressive squamous cell carcinoma in organ transplant recipients [published online December 5, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.4406