Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada
| Autor: | Christina K Park, Kinwah Fung, Paula A. Rochon, Peter C. Austin, An-Wen Chan, Erin Dahlke, Jessica Kitchen |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Skin Neoplasms medicine.medical_treatment Population Dermatology 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Epidemiology Medicine Humans Registries education Melanoma Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Skin Ontario education.field_of_study business.industry Incidence (epidemiology) Incidence Hazard ratio Immunosuppression Odds ratio Organ Transplantation Middle Aged Survival Analysis Confidence interval Transplant Recipients Standardized mortality ratio 030220 oncology & carcinogenesis Case-Control Studies Female business Follow-Up Studies |
| Zdroj: | Journal of the American Academy of Dermatology. 83(3) |
| ISSN: | 1097-6787 |
| Popis: | Background Risk of melanoma is increased with potentially worse outcomes after solid organ transplant. Objective To estimate the incidence, stage, and survival in transplant recipients with melanoma. Methods Population-based, retrospective, observational study using linked administrative databases. Adults receiving their first solid organ transplant from 1991 through 2012 were followed to December 2013. Results We identified 51 transplant recipients with melanoma, 11 369 recipients without melanoma, and 255 matched patients with melanoma from the nontransplant population. Transplant recipients were at increased risk of melanoma (standardized incidence ratio, 2.29; 95% confidence interval [CI], 2.07-2.49) and more likely to be diagnosed at stages II through IV (adjusted odds ratio, 4.29; 95% CI, 2.04-9.00) compared with the nontransplant population. Melanoma-specific mortality was increased in transplant recipients compared with the nontransplant population (adjusted hazard ratio, 1.93; 95% CI, 1.03-3.63). Among transplant recipients, all-cause mortality was increased after melanoma compared with those without melanoma (stage T1/T2: adjusted hazard ratio, 2.18; 95% CI, 1.13-4.21; T3/T4: adjusted hazard ratio, 4.07; 95% CI, 2.36-7.04; III/IV: adjusted hazard ratio, 7.92; 95% CI, 3.76-16.70). Limitations The databases did not contain data on immunosuppressive drugs; ascertainment of melanoma metastasis relied on pathology reports. Conclusion Melanoma after solid organ transplant is more often diagnosed at a later stage and leads to increased mortality, even for early-stage tumors. |
| Databáze: | OpenAIRE |
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