Hauttumoren bei organtransplantierten Patienten

Abstract

Transplant recipients are at significantly increased risk of cancer development as a long term complication. Skin cancer is the most common cancer, representing 40-50% of post transplant malignancies. In the first 10 years post transplantation, some 15%-40% of patients develop skin cancer, primarily squamous cell carcinoma and basal cell carcinoma, but also melanoma, Merkel cell carcinoma and virally-induced Kaposi sarcoma. The management of skin cancer includes secondary prophylaxis and address attention to areas of widespread actinic damage, usually with topical agents. In high risk skin cancer or metastatic disease a substantial reduction in immunosuppression to switching to mTOR inhibitors appears to substantially improve the prognosis. The management of the individual tumor types is discussed; in general it follows the current guidelines.

Immune Checkpoint Inhibitors in Solid Organ Transplant Recipients With Advanced Skin Cancers—Emerging Strategies for Clinical Management

“…For unresectable locally advanced or metastatic cSCC, systemic treatment with ICI should be discussed based on national guidelines in the setting of an interdisciplinary skin cancer board. 1,12,13 In cases of oligometastatic cSCC, surgery followed by adjuvant radiotherapy (RT) has shown good results. 14 RT can be considered as a possible curative or palliative treatment option in case of unresectable cSCC.…”

Merkel cell carcinoma of skin-current controversies and recommendations

“…39 A substantial reduction in immunosuppressive drugs in immunosuppressed patients by switching to mTOR inhibitors appears to substantially improve the prognosis in a series with miscellaneous skin neoplasms, although this may not always work in others. 40–43 We await more reports on MCC in the future.…”

Randomised controlled trial to evaluate the influence of mHealth and eHealth skin cancer prevention education among young organ transplant recipients: the HIPPOlino intervention study

“…Children and adolescents who were transplanted in early childhood represent a high-risk group. Forty to fifty per cent of all incident tumour illnesses after transplantation are reported to be tumours of the skin 4. The risk of developing non-melanoma skin cancer is 65–250 times higher in OTRs compared with immunocompetent persons 5.…”