Aggressive Squamous Cell Carcinoma in Organ Transplant Recipients

Joana Lanz, Jan Nico Bouwes Bavinck, Marlies Westhuis, Koen D. Quint, Catherine A. Harwood, Shaaira Nasir, Vanessa Van-de-Velde, Charlotte M. Proby, Carlos Ferrándiz, Roel E. Genders, Véronique Del Marmol, Giulia Forchetti, Jürg Hafner, Domenic G. Vital, Domenic G. Vital

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54 Citations (Scopus)
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Importance: Squamous cell carcinoma (SCC) is the most frequent malignant neoplasm found in solid organ transplant recipients and is associated with a more aggressive disease course and higher risk of metastasis and death than in the general population.

Objectives: To report the clinicopathologic features of and identify factors associated with aggressive SCC in solid organ transplant recipients.

Methods: This retrospective multicentric case series included 51 patients who underwent solid organ transplantation and were found to have aggressive SCC, defined by nodal or distant metastasis or death by local progression of primary SCC. Standard questionnaires were completed by the researchers between July 18, 2005, and January 1, 2015. Data were analyzed between February 22, 2016, and July 12, 2016.

Results: Of the 51 participants, 43 were men and 8 were women, with a median age of 51 years (range, 19-71 years) at time of transplantation and 62 years (range, 36-77 years) at time of diagnosis of aggressive SCC. The distribution of aggressive SCC was preferentially on the face (34 [67%]) and scalp (6 [12%]), followed by the upper extremities (6 [12%]). A total of 21 tumors (41%) were poorly differentiated, with a median tumor diameter of 18.0 mm (range, 4.0-64.0 mm) and median tumor depth of 6.2 mm (range, 1.0-20.0 mm). Perineural invasion was present in 20 patients (39%), while 23 (45%) showed a local recurrence. The 5-year overall survival rate was 23%, while 5-year disease-specific survival was 30.5%.

Conclusions and Relevance: Results of this case series suggest that anatomical site, differentiation, tumor diameter, tumor depth, and perineural invasion are important risk factors in aggressive SCC in solid organ transplant recipients.

Original languageEnglish
Pages (from-to)66-71
Number of pages6
JournalJAMA Dermatology
Issue number1
Early online date5 Dec 2018
Publication statusPublished - 1 Jan 2019

ASJC Scopus subject areas

  • Dermatology


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