Skin Cancers In Organ Transplant Patients Differ Clinically And Pathologically

A DGReview of "Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients: Clinicopathologic Study of 176 Cases"

Archives of Dermatology

By Elda Hauschildt

Skin cancers in organ transplant patients show clinicopathological differences from those in non-transplant patients, French researchers report.

For the transplant patients, the basal cell cancers develop at a younger age, more often in males, and more frequently in sun-protected sites, say investigators, led by Jean Kanitakis, MD, of Edouard Herriot Hospital in Lyon, France. The transplant patients also have a higher frequency of superficial subtypes of basal cell cancers.

The researchers reviewed 176 histologically proven basal cell cancers among 146 of 2029 transplant patients, for an incidence rate of 7.2%.

Study participants, both children and adults, were followed for up to 20 years. Sixty eight percent were men. Control carcinomas were 153 random samples excised from non-immunosuppressed patients treated at the same institution.

"This incidence is likely to be underestimated since some basal cell carcinomas may be destroyed by family doctors without histological confirmation, especially because many belong to the superficial subtype that is amendable to non-surgical treatment," the investigators comment. They found a 3.4-fold lower incidence for basal cell carcinomas than for squamous cell carcinomas.

Transplant recipients are generally at increased risk of developing various cancers, the investigators say. Pre-malignant and malignant cutaneous tumours, including both basal cell carcinomas and squamous cell carcinomas, are most common.

Results indicate basal cell carcinomas developed an average of 6.9 years following transplantation. These occurred sooner in heart and kidney transplant patients.

Transplant recipients developed the cancers at a mean age of 54.6 years, compared to 69.8 years in non-transplant patients. The male to female ratio was 4.8 to 1 in transplant patients and 1.3 to 1 in non-transplant patients.

Extracephalic locations of tumours were significantly more frequent in transplant patients (37.5%) compared with controls 24.5%).

Arch Dermatol 2003;139:9:1133-1137. "Basal Cell Carcinomas Developing in Solid Organ Transplant Recipients: Clinicopathologic Study of 176 Cases"

Copyright © 1995-2003 Doctor's Guide Publishing Limited.

This article posted September 29, 2003.