Subsequent Squamous- and Basal-Cell Carcinomas in Kidney-Transplant Recipients After the First Skin Cancer: Cumulative Incidence and Risk Factors

Autor: Rein Willemze, Jeroen R. J. Edelbroek, Hermina C. Wisgerhof, Jan Nico Bouwes Bavinck, Geert W. Haasnoot, Frans H.J. Claas, Johan W. de Fijter
Rok vydání: 2010
Předmět:
Male
Oncology
medicine.medical_specialty
Skin Neoplasms
Time Factors
medicine.medical_treatment
Azathioprine
Risk Factors
Prednisone
Internal medicine
medicine
Carcinoma
Humans
Skin cancer Squamous-cell carcinoma Basal-cell carcinoma Transplantation Incidence Risk factors immunosuppressive therapy mediterranean population renal-transplantation organ-transplantation australia azathioprine queensland regimens
Cumulative incidence
Proportional Hazards Models
Retrospective Studies
Transplantation
integumentary system
Proportional hazards model
business.industry
Incidence
Retrospective cohort study
Immunosuppression
medicine.disease
Kidney Transplantation
Carcinoma
Basal Cell
Carcinoma
Squamous Cell
Sunlight
Female
Neoplasm Recurrence
Local
Skin cancer
business
Immunosuppressive Agents
medicine.drug
Zdroj: Transplantation, 89(10), 1231-1238
ISSN: 0041-1337
DOI: 10.1097/tp.0b013e3181d84cdc
Popis: Background The risk of skin cancer is highly increased in kidney-transplant recipients (KTR), but the risk of subsequent skin cancers is less well studied. The aim of this study was to estimate the cumulative incidence of subsequent squamous- and basal-cell carcinomas (BCCs) and to analyze potential risk factors. Methods All histologically confirmed skin cancers between 1966 and 2006 were included in the study and counted. Cumulative incidences of subsequent squamous- and BCCs were calculated using Kaplan-Meier survival analyses. For the analyses of risk factors, we used Cox proportional hazard analyses. Results A total of 239 (13%) of 1906 KTR developed skin cancer of whom 222 were diagnosed in our hospital. Altogether 167 (75%) of these 222 patients developed multiple skin cancers. The cumulative incidence of a second skin cancer increased from 32%, 1 year, to 59%, 3 years, and 72%, 5 years after the first skin cancer. KTR who started with squamous-cell carcinoma (SCC) mainly developed SCC and recipients who started with BCC mainly developed BCC as second skin cancer. Immunosuppression with azathioprine in combination with prednisone was associated with a significantly increased risk of subsequent SCCs but not with subsequent BCCs. Conclusion Skin cancer multiplicity is common in KTR. Patients with a first skin cancer are at increased risk for more skin cancers and need to be carefully checked for subsequent skin cancers.
Databáze: OpenAIRE
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