Nonmelanoma skin cancer after renal transplantation: a single‐center experience in 1736 transplantations

Zavos, G.; Karidis, Nikolaos P.; Tsourouflis, Gerasimos; Bokos, John; Diles, Konstantinos; Sotirchos, George; Theodoropoulou, Eleni; Kostakis, Alkiviadis

doi:10.1111/j.1365-4632.2011.04939.x

Cited by 49 publications

(62 citation statements)

References 22 publications

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“…9 Unlike in the general population, squamous cell skin cancers can be quite aggressive in transplant recipients, with a high recurrence rate, metastasis, and death. [10][11][12] Reduction in the incidence and complications associated with malignancy would be a major advance for kidney transplant recipients.…”

Section: Introductionmentioning

confidence: 99%

Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data

Knoll

Kokolo

Mallick

et al. 2014

BMJ

285

190

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Objective To examine risk of malignancy and death in patients with kidney transplant who receive the immunosuppressive drug sirolimus.Design Systematic review and meta-analysis of individual patient data.Data sources Medline, Embase, and the Cochrane Central Register of Controlled Trials from inception to March 2013.Eligibility Randomized controlled trials comparing immunosuppressive regimens with and without sirolimus in recipients of kidney or combined pancreatic and renal transplant for which the author was willing to provide individual patient level data. Two reviewers independently screened titles/abstracts and full text reports of potentially eligible trials to identify studies for inclusion. All eligible trials reported data on malignancy or survival. Results The search yielded 2365 unique citations. Patient level data were available from 5876 patients from 21 randomized trials. Sirolimus was associated with a 40% reduction in the risk of malignancy (adjusted hazard ratio 0.60, 95% confidence interval 0.39 to 0.93) and a 56% reduction in the risk of non-melanoma skin cancer (0.44, 0.30 to 0.63) compared with controls. The most pronounced effect was seen in patients who converted to sirolimus from an established immunosuppressive regimen, resulting in a reduction in risk of malignancy (0.34, 0.28 to 0.41), non-melanoma skin cancer (0.32, 0.24 to 0.42), and other cancers (0.52, 0.38 to 0.69). Sirolimus was associated with an increased risk of death (1.43, 1.21 to 1.71) compared with controls.Conclusions Sirolimus was associated with a reduction in the risk of malignancy and non-melanoma skin cancer in transplant recipients. The benefit was most pronounced in patients who converted from an established immunosuppressive regimen to sirolimus. Given the risk of mortality, however, the use of this drug does not seem warranted for most patients with kidney transplant. Further research is needed to determine if different populations, such as those at high risk of cancer, might benefit from sirolimus.

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Section: Introductionmentioning

confidence: 99%

Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data

Knoll

Kokolo

Mallick

et al. 2014

BMJ

285

190

View full text Add to dashboard Cite

show abstract

“…1,2 However, the incidence of skin cancer after transplant varies from 2% to 30%. [3][4][5][6][7][8] This variation may be caused by differences in the level of sun exposure. Patients living in a temperate climate may have a much lower risk of developing skin cancer compared with patients living in areas with high levels of sun exposure.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 The main risk factors that predispose to skin cancer include the use of immunosuppressive drugs, viral infections, sunlight exposure, older age at transplant, and male sex. [5][6][7][8][9][10][11] This study sought to determine the incidence of skin cancer and identify the risk factors for skin cancer in kidney transplant recipients at a kidney transplant program in Turkey.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Tepeoğlu

Ayva²,

Atılgan³

et al. 2014

Exp Clin Transplant

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Objectives: Solid-organ transplant recipients have a high risk of developing nonmelanoma skin cancers. This study sought to determine the incidence of skin cancer and identify possible risk factors for skin cancer in kidney transplant recipients. Materials and Methods: Nonmelanoma skin cancer was diagnosed and confirmed with histology in 33 of 1275 kidney transplant recipients (2.6%). Demographic and clinical findings were reviewed retrospectively. Results: Nonmelanoma skin cancers included squamous cell carcinoma in 10 patients (30%), basal cell carcinoma in 9 patients (27%), Kaposi sarcoma in 9 patients (27%), squamous cell carcinoma in situ in 3 patients (9%), and cutaneous lymphoma in 2 patients (6%). The ratio of squamous cell carcinoma to basal cell carcinoma was 1.1:1. The mean time from transplant to skin cancer diagnosis was 65 ± 55 months (range, 0-180 mo). Immunosuppressive therapy was based on cyclosporine in 22 patients (67%), tacrolimus in 8 patients (24%), and combination therapy (cyclosporine and azathioprine) in 3 patients (9%). Conclusions: Nonmelanoma skin cancer is an important clinical problem in kidney transplant recipients. Interventions that may benefit kidney transplant recipients may include intensive patient education, protection against sun exposure, and dermatologic screening programs.

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“…The most common malignancy found in all transplant recipients is nonmelanoma skin cancer (NMSC), and the incidence is approximately 2.2% in renal transplants, according to one study (13). This increased incidence of NMSC is caused by immunosuppression, and the incidence of NMSC is up to 20-fold greater in renal transplant recipients when compared to the general population (13).…”

Section: 5non-melanoma Skin Cancermentioning

confidence: 99%

“…This increased incidence of NMSC is caused by immunosuppression, and the incidence of NMSC is up to 20-fold greater in renal transplant recipients when compared to the general population (13). Of the two most common NMSC histological types, squamous cell carcinoma (SCC) is typically more aggressive, recurrent, and metastatic than basal cell carcinoma (BCC).…”

Section: 5non-melanoma Skin Cancermentioning

confidence: 99%

Dermatological diseases in patients with chronic kidney disease

Gagnon¹,

Desai²

2013

J Nephropathol

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Nonmelanoma skin cancer after renal transplantation: a single‐center experience in 1736 transplantations

Abstract: Nonmelanoma skin cancer remains a significant source of morbidity and mortality in RTRs, and post-transplant surveillance should be increased.

Cited by 49 publications

References 22 publications

Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data

Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data

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Dermatological diseases in patients with chronic kidney disease

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