The increased risk for developing aggressive squamous cell carcinomas (SCCs) in solid organ transplant recipients (SOTRs) may be successfully managed by closely adhering to current dermatologic surveillance recommendations and maintaining a marginally lower threshold for biopsy of any suspicious lesions, according to the results of a recent retrospective cohort study published in JAMA Dermatology.
The investigators sought to compare outcomes associated with aggressive behavior of SCCs among SOTRs and high-risk immunocompetent individuals. Study participants included 58 SOTRs and 40 immunocompetent patients with ≥1 histopathologically confirmed SCC evaluated at the Yale Transplant Dermatology Clinic in New Haven, Connecticut, between January 1, 2008 and December 31, 2015. Mean age was 61.3±8.4 in the 58 SOTR patients and 69.8±10.9 in the 40 immunocompetent participants. SOTRs had been immunosuppressed for a mean of 14.6±9.2 years (range 2 to 37 years).
Annual frequency of patient visits and annual biopsy rates were both calculated using variable follow-up time per patient. Patient visit frequency (mean, 4±2 vs 3±2; P =.02) and annual biopsy rate (mean, 6±4 vs 5±3; P =.04) were significantly higher in the SOTR group vs the immunocompetent group.
Patients in the SOTR group developed SCCs that did not appear to behave more aggressively than SCCs that developed in the immunocompetent group. All SCCs thicker than 2 mm were reported in the SOTR patients; however, no significant difference in tumor depth was observed between the two groups of participants.
The investigators concluded that the higher risk for SCCs in the SOTR population and the potentially more aggressive clinical course in these patients may be successfully managed at a level comparable to high-risk immunocompetent individuals by adhering to strict dermatologic screening guidelines.
Cheng JY, Li FY, Ko CJ, Colegio OR. Cutaneous squamous cell carcinomas in solid organ transplant recipients compared with immunocompetent patients [published online
November 22, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.4506