Identification of Risk Factors for Multiple Non-Melanoma Skin Cancers in Italian Kidney Transplant Recipients

Abstract

Background and objectives: Non-melanoma skin cancers (NMSCs) represent the most frequently encountered malignancy in organ transplant recipients and their incidence increases proportionally to the duration of immunosuppression. Furthermore, patients of this group often develop multiple and more aggressive cancers and, to date, risk factors for the development of multiple NMSCs have not been yet established. The present study aimed to identify risk factors for multiple NMSCs in a cohort of Italian kidney transplant recipients (KTRs). Materials and Methods: We consecutively included all KTRs referring to two post-transplant outpatient clinics of North-Western Italy between 2001 and 2017. In this cohort, we evaluated different clinical (endogenous and exogenous) risk factors in order to establish their correlation with NMSCs. Results: 518 KTRs were included, of which 148 (28.6%) developed keratinocyte cancers, with a single tumor in 77 subjects, two skin cancers in 31 patients, 3 in 21 patients, whereas at least 4 NMSCs developed in 19 KTRs. We observed an increased risk of the development of cutaneous neoplasms for the male gender, old age at transplantation (>50 years), light phototype, solar lentigo, history of sunburns, or chronic actinic damage. Considering patients affected by multiple keratinocyte neoplasms, we observed a significant association of actinic damage and solar lentigo with an increased risk of NMSCs; their significance was confirmed even at the multivariable model. Conclusions: Our results confirm the role played by chronic cutaneous actinic damage in carcinogenesis on KTRs and highlight the significance of individualized periodic dermatological screening.

Multiple Basal Cell Carcinomas in Immunocompetent Patients

“…Interestingly, the mean interval between the appearance of the first and second BCC was 16.4 months which decreased to 14.6 months between the second and the third, and further decreased to 10.1 months between the third and the fourth tumor. These data are like those also observed in a transplanted patient's cohort, in which we proved a progressive reduction in the latency time between one neoplasm and the subsequent [23].…”

Alteraciones neoplásicas en el paciente trasplantado renal. Una revisión sistemática

“…En su estudio, Zavaratto E et al ( 2019), llevaron a cabo un análisis acerca de los principales factores de riesgo para el cáncer de piel no melanoma; siendo este, el tipo de cáncer de piel más evidenciado en nuestros resultados, y llegaron a concluir que el sexo masculino, la edad avanzada en el momento del trasplante, el fototipo claro, el lentigo solar y los antecedentes de quemaduras solares así como de daño actínico crónico contribuyen de manera significativa en la aparición de este tipo de tumores. De esta forma evidenciaron la necesidad de llevar a cabo un cribado dermatológico para cada uno de los trasplantados renales de forma periódica 48 .…”

Risk Factors and Skin Cancer in Adults From the City of Machala - Ecuador

“…Constitutional factors include personal or family history, light or red hair, sensitivity to sun exposure, multiple melanocytic nevi, among others (Alonso & Salerni, 2016;Caparrotti et al, 2020;Maubec, 2020). The best established and most important risk factor is ultraviolet (UV) radiation (Cristy & Garrido Jessica, 2018;Llombart et al, 2017;Zavattaro et al, 2019).…”