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Aggressive Squamous Cell Carcinoma in Solid Organ Transplant Recipients

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Key Points

  • Aggressive SCC most commonly presented on the face and scalp, followed by the upper extremities.
  • A total of 21 tumors (41%) were poorly differentiated, with a median tumor diameter of 18.0 mm and median tumor depth of 6.2 mm.
  • The 5-year overall survival rate was 23%, while 5-year disease-specific survival was 30.5%.

Squamous cell carcinoma (SCC) is the most frequently diagnosed cancer in recipients of a solid organ transplant. When organ transplant recipients are diagnosed with SCC, they are also at higher risk for a more aggressive disease course, metastasis, and death than the general population. Researchers sought to identify factors associated with the development of aggressive SCC in organ transplant recipients. Their findings were published by Lanz et al in JAMA Dermatology.

Methods

Fifty-one participants were included in the study. They had all undergone solid organ transplantation and were found to have aggressive SCC, defined by nodal or distant metastasis or death by local progression of primary SCC. Forty-three participants were men and eight were women; the median age at time of transplant was 51 years and the median age at time of diagnosis of aggressive SCC was 62 years. Questionnaires were completed by researchers over a 14.5-year period.

Findings

Aggressive SCC most commonly presented on the face (67%) and scalp (12%), followed by the upper extremities (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%.

The authors concluded, “Taken together, our case series confirms that anatomical site, differentiation, tumor diameter, tumor depth, and perineural invasion are important risk factors in aggressive SCC in solid organ transplant recipients. We also demonstrated a poor prognosis of aggressive SCC.”

Disclosure: The study authors’ full disclosures can be found at jamanetwork.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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