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Oteiza Rius I, Morelló Vicente A, Aguado Gil L. Squamous cell carcinoma in solid organ transplant recipients: Review of the literature. Med Clin (Barc) 2024:S0025-7753(24)00370-1. [PMID: 38981824 DOI: 10.1016/j.medcli.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 07/11/2024]
Abstract
Solid organ transplant recipients (SOTRs) exhibit an elevated incidence and aggressiveness of squamous cell carcinomas (SCCs) due to their immunosuppression. These tumors are associated with a heightened risk of metastasis and increased mortality. Therefore, an appropriate management of these patients is essential to improve their prognosis. Given the scarcity of studies on non-melanoma skin cancers (NMSCs) in SOTRs, this article aims to summarize and analyze the evidence gathered to date regarding therapeutic approaches, personalized monitoring, and prevention strategies for SCCs in these patients. Additionally, recent advancements in understanding SCCs within this patient group are also documented.
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Affiliation(s)
- Inés Oteiza Rius
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España
| | - Ana Morelló Vicente
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España.
| | - Leyre Aguado Gil
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España
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2
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Sarigöl Ordin Y, Demir Korkmaz F, Kankaya EA, Yeşilyaprak T. Factors Affecting Knowledge Levels and Protective Behaviors to Prevent the Development of Skin Cancer in Organ Transplant Recipients as a High-Risk Group. EXP CLIN TRANSPLANT 2023; 21:607-614. [PMID: 35037604 DOI: 10.6002/ect.2021.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Organ transplantrecipients are at high risk of skin cancer due to immunosuppressant therapy. This study investigated the factors affecting organ transplant recipients' knowledge and protective behaviors to prevent the development of skin cancer. MATERIALS AND METHODS This was a cross-sectional descriptive study of kidney (n = 82) and liver (n = 31) transplant recipients seen at our hospitals in Turkey from June 2019 to February 2020. A sociodemographic and clinical characteristics form, the Skin Cancer and Sun Knowledge scale, the Sun Protection Behavior questionnaire, and the General Self-Efficacy scale were used to collect data. RESULTS The mean age of organ transplant recipients was 46.63 ± 13.24 years. Self-efficacy and awareness that transplant increases the risk of skin cancer are 2 characteristics that affected the participants' knowledge level. The type of graft (kidney) affected participants' behavior in avoiding outdoor exposure between the hours of 10 am and 4 pm. Green/blue eye color and self-efficacy affected the participants' hatwearing behavior. These details showed that, as the patients' sensitivity and self-efficacy increased, their levels of knowledge and sun protection behaviors were positively affected. CONCLUSIONS The knowledge level of patients was affected by (1) awareness that transplant is associated with an increased risk of skin cancer and (2) high levels of self-efficacy. We observed that (1) organ transplant recipients with high self-efficacy and kidney transplant recipients were more likely to avoid outdoor exposure between 10 am and 4 pm and that (2) organ transplant recipients with green/blue eyes and high levels of selfefficacy were more likely to wear a hat when outdoors. Organ transplant teams should provide education and counseling about skin cancer and sun protection in the follow-up care of transplant recipients.
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Affiliation(s)
- Yaprak Sarigöl Ordin
- From the Department of Surgical Nursing, Dokuz Eylül University Nursing Faculty, Izmir, Turkey
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3
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Thet Z, Lam AK, Ng SK, Aung SY, Han T, Ranganathan D, Borg J, Pepito C, Khoo TK. Comparison of skin cancer awareness and sun protection behaviours between renal transplant recipients and patients with glomerular disease treated with immunosuppressants. Nephrology (Carlton) 2020; 26:294-302. [PMID: 34308553 DOI: 10.1111/nep.13840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is no previous study that compare skin cancer awareness and photoprotective behaviours between renal transplant recipients (RTR) and patients with glomerular disease (GD). OBJECTIVES/METHODS Sixty-one RTR and 51 patients with GD were given a self-reported questionnaire to evaluate skin cancer awareness and photoprotective behaviours in this cross-sectional study. The former group received a formal education on skin cancer and the latter an informal session prior to immunosuppressant use. RESULTS Ninety-three percent (n = 57) of RTRs and 88% (n = 45) of patients with GD responded to the survey. Majority of participants from both groups were aware that ultraviolet radiation could play a role in the occurrence of skin cancers and the awareness increased in participants with higher education (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.15-1.95, P = .003). Ninety-eight percent vs 71% were aware that immunosuppressants can increase the risk of developing cancer (P < .001) and higher awareness was noted in younger participants (OR = 0.92, 95% CI = 0.87-0.97, P = .003). Suboptimal photoprotective behaviours (sun avoidance, sunscreen usage and sun-protective clothing) were noted in both cohorts and slightly lower sun protection rates were reported in RTR when compared with patients having GD. The level of sun protective measures in RTR based on high, moderate and minimal use of photoprotective measures were 21%, 46% and 33%, respectively. In terms of patients with GD, the latter practices were 13%, 50% and 37%, respectively (P = .560). Higher educational status was significantly associated with better sunscreen usage in RTR (P = .017) whereas this finding was not observed in patients with GD. CONCLUSION Patients with GD and RTR should have formal education on the risks of skin cancers before starting immunosuppressants. Follow-up education and surveillance is required to improve skin protective practices in these patients.
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Affiliation(s)
- Zaw Thet
- School of Medicine, Griffith University, Brisbane, Queensland, Australia.,Department of Nephrology, Central Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Alfred K Lam
- School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Shu-Kay Ng
- School of Medicine, Griffith University, Brisbane, Queensland, Australia
| | - Soe Yu Aung
- Department of Oncology, Central Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
| | - Thin Han
- Department of Nephrology, Central Queensland Hospital and Health Service, Brisbane, Queensland, Australia.,Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
| | - Dwarakanathan Ranganathan
- School of Medicine, Griffith University, Brisbane, Queensland, Australia.,Department of Nephrology, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Jennifer Borg
- Department of Nephrology, Central Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Christine Pepito
- Department of Nephrology, Central Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Tien K Khoo
- School of Medicine, Griffith University, Brisbane, Queensland, Australia.,School of Medicine, University of Wollongong, New South Wales, Australia
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4
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Khandelwal AR, Kent B, Hillary S, Alam MM, Ma X, Gu X, DiGiovanni J, Nathan CAO. Fibroblast growth factor receptor promotes progression of cutaneous squamous cell carcinoma. Mol Carcinog 2019; 58:1715-1725. [PMID: 31254372 DOI: 10.1002/mc.23012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/14/2022]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a keratinocyte-derived invasive and metastatic tumor of the skin. It is the second-most commonly diagnosed form of skin cancer striking 200 000 Americans annually. Further, in organ transplant patients, there is a 65- to 100-fold increased incidence of cSCC compared to the general population. Excision of cSCC of the head and neck results in significant facial disfigurement. Therefore, increased understanding of the mechanisms involved in the pathogeneses of cSCC could identify means to prevent, inhibit, and reverse this process. In our previous studies, inhibition of fibroblast growth factor receptor (FGFR) significantly decreased ultraviolet B-induced epidermal hyperplasia and hyperproliferation in SKH-1 mice, suggesting an important role for FGFR signaling in skin cancer development. However, the role of FGFR signaling in the progression of cSCC is not yet elucidated. Analysis of the expression of FGFR in cSCC cells and normal epidermal keratinocytes revealed protein overexpression and increased FGFR2 activation in cSCC cells compared to normal keratinocytes. Further, tumor cell-specific overexpression of FGFR2 was detected in human cSCCs, whereas the expression of FGFR2 was low in premalignant lesions and normal skin. Pretreatment with the pan-FGFR inhibitor; AZD4547 significantly decreased cSCC cell-cycle traverse, proliferation, migration, and motility. Interestingly, AZD4547 also significantly downregulated mammalian target of rapamycin complex 1 and AKT activation in cSCC cells, suggesting an important role of these signaling pathways in FGFR-mediated effects. To further bolster the in vitro studies, NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ mice with SCC12A tumor xenografts treated with AZD4547 (15 mg/kg/bw, twice weekly oral gavage) exhibited significantly decreased tumor volume compared to the vehicle-only treatment group. The current studies provide mechanistic evidence for the role of FGFR and selectively FGFR2 in the early progression of cSCC and identifies FGFR as a putative therapeutic target in the treatment of skin cancer.
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Affiliation(s)
- Alok R Khandelwal
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.,Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Burton Kent
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Savage Hillary
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Md Maksudul Alam
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Xiaohua Ma
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Xin Gu
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - John DiGiovanni
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, Texas
| | - Cherie-Ann O Nathan
- Department of Otolaryngology, Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.,Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, Louisiana.,Department of Surgery, Overton Brooks Veterans Affairs Hospital, Shreveport, Louisiana
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5
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Peters FS, Peeters AMA, van den Bosch TPP, Mooyaart AL, van de Wetering J, Betjes MGH, Baan CC, Boer K. Disrupted regulation of serpinB9 in circulating T cells is associated with an increased risk for post-transplant skin cancer. Clin Exp Immunol 2019; 197:341-351. [PMID: 31059128 PMCID: PMC6693965 DOI: 10.1111/cei.13309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 12/14/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a serious complication after organ transplantation and patients benefit from an early risk assessment. We hypothesized that functional differences in circulating T cells may represent risk factors for post‐transplant cSCC development. Here, we analysed genome‐wide DNA methylation of circulating T cells of kidney transplant recipients before the clinical onset of cSCC, to identify differences associated with post‐transplant cSCC development. This analysis identified higher DNA methylation of SERPINB9, which is an intracellular inhibitor of granzyme B, a protein that induces apoptosis in target cells. High DNA methylation of SERPINB9 in circulating T cells was confirmed in a second patient cohort during recurrent cSCC, indicating that high SERPINB9 methylation represents a persistent risk factor for cSCC development. At the functional level, the inverse correlation between DNA methylation and messenger RNA expression present in non‐cSCC patients was absent in the cSCC patients. Also, a significant difference in serpinB9 protein expression between cSCC patients and non‐cSCC patients was observed. It was concluded that disturbed regulation of serpinB9 in circulating T cells represents a novel risk factor for post‐transplant cSCC in kidney transplant recipients.
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Affiliation(s)
- F S Peters
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A M A Peeters
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - T P P van den Bosch
- Department of Pathology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - A L Mooyaart
- Department of Pathology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - J van de Wetering
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M G H Betjes
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - C C Baan
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Boer
- Rotterdam Transplant Group, Department of Internal Medicine, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
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6
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Cohen BE, Krivitskiy I, Bui S, Forrester K, Kahn J, Barbers R, Ngo B. Comparison of Skin Cancer Incidence in Caucasian and Non-Caucasian Liver Vs. Lung Transplant Recipients: A Tale of Two Regimens. Clin Drug Investig 2019; 39:197-203. [PMID: 30471069 DOI: 10.1007/s40261-018-0732-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Organ transplantation is a significant risk factor for the development of skin cancer. The impact of skin type, immunosuppressive regimens, and photosensitizing agents requires further study. OBJECTIVE The objective of this study was to compare skin cancer development between Caucasian and non-Caucasian transplant recipients at the University of Southern California. METHODS We performed a retrospective chart review of lung and liver transplantations to determine the incidence of post-transplant skin cancer. Participants included patients who underwent lung or liver transplantation between 2005 and 2013 at our institution. Patients included in the study were limited to those who survived through the study observation period. RESULTS We analyzed 475 patients who underwent transplantation, including 370 liver transplant recipients and 105 lung transplant recipients. Among these, 46.3% identified as Caucasian, while 53.7% were non-Caucasian. Over a mean follow-up of 7.9 years, 11.8% of Caucasian patients developed at least one skin cancer, compared with 2.7% of non-Caucasians (p < 0.001). However, irrespective of race, skin cancer development was significantly greater in lung compared with liver transplant recipients (20.0% vs. 3.2%, p < 0.001). The standard immunosuppressive and prophylactic regimens were mycophenolate mofetil and tacrolimus based for both transplants. Mycophenolate mofetil was maintained throughout the course in lung transplant patients, whereas this agent was reduced and terminated when possible in liver transplant recipients. In addition, during the years examined, voriconazole, a known photosensitizing agent, was used in lung transplant recipients to prevent aspergillosis. CONCLUSIONS Fair skin type increases post-transplant skin cancer development, irrespective of the immunosuppressive regimen. A higher risk of skin cancer is associated with different regimens; in particular photosensitizing agents may increase risk in transplant recipients.
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Affiliation(s)
- Brandon E Cohen
- Department of Dermatology, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
| | - Igor Krivitskiy
- School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sarah Bui
- School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kevin Forrester
- School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Jeffrey Kahn
- Department of Hepatology, University of Southern California, Los Angeles, CA, USA
| | - Richard Barbers
- Department of Pulmonology, University of Southern California, Los Angeles, CA, USA
| | - Binh Ngo
- Department of Dermatology, University of Southern California, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.,Rose Salter Medical Research Foundation, Newport Coast, CA, USA
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7
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Haney MO, Ordin YS, Arkan G. Skin Cancer-Sun Knowledge and Sun Protection Behaviors of Liver Transplant Recipients in Turkey. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:137-144. [PMID: 28887780 DOI: 10.1007/s13187-017-1279-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The aim of this study was to compare liver transplant recipients (LTRs) with the general population regarding their knowledge of skin cancer, sun health, sun protection behaviors, and affecting factors. This cross-sectional study was conducted in Turkey between March 2016 and September 2016 with 104 LTRs and 100 participants from the general population group (GPG). The mean age of the LTRs was 53.2 ± 11.8 and that of the GPG was 42.7 ± 14.5. The LTRs' skin cancer and sun knowledge were significantly lower than in the GPG, but there was no difference between the two groups in terms of their sun protection behavior scores. The most commonly used sun protection behaviors of LTRs were not being outside and not sunbathing between 10 a.m. and 4 p.m., wearing clothing that covers the skin, and avoiding the solarium. Behaviors commonly practiced by the GPG were wearing sunglasses, wearing sunscreen with a sun protection factor of 15 or higher before going outside, wearing sunscreen at the beach, while swimming or doing physical activity outside, and reapplying it every 2 h. Results of our study will contribute to the development of education and training programs for LTRs on skin cancer. The results also demonstrated the importance of practicing adequate sun protection behaviors which will certainly impact their future health.
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Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey
| | - Yaprak Sarigol Ordin
- Surgical Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey
| | - Gulcihan Arkan
- Public Health Nursing Department, Dokuz Eylul University Faculty of Nursing, Dokuz Eylul University Health Campus, Inciralti, 35340, Izmir, Turkey.
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8
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Chan AW, Fung K, Austin PC, Kim SJ, Singer LG, Baxter NN, Alhusayen R, Rochon PA. Improved keratinocyte carcinoma outcomes with annual dermatology assessment after solid organ transplantation: Population-based cohort study. Am J Transplant 2019; 19:522-531. [PMID: 29900669 DOI: 10.1111/ajt.14966] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 01/25/2023]
Abstract
Solid organ transplant recipients have a high risk of keratinocyte carcinoma (non-melanoma skin cancer). Consensus-based transplant guidelines recommend annual dermatological examination but the impact on skin cancer-related outcomes is unclear. We conducted a population-based, retrospective, inception cohort study using administrative health databases in Ontario, Canada to evaluate the association between adherence to annual dermatology assessments (time-varying exposure) and keratinocyte carcinoma-related morbidity and mortality after transplantation. The primary outcome was the time to first advanced (highly morbid or fatal) keratinocyte carcinoma. Among 10 183 adults receiving their first transplant from 1994 to 2012 and followed for a median of 5.44 years, 4.9% developed an advanced keratinocyte carcinoma after transplant. Adherence to annual dermatology assessments for at least 75% of the observation time after transplant was associated with a 34% reduction in keratinocyte carcinoma-related morbidity or death compared with adherence levels below 75% (adjusted hazard ratio 0.66, 95% CI 0.48-0.92). Adherence levels were universally low (median proportion of time spent in adherence 0%, inter-quartile range 0-27%). Only 45% of transplant recipients had ever seen a dermatologist and 2.1% were fully adherent during the entire observation period. Strategies are needed to improve adherence rates in order to help decrease long-term morbidity after transplant.
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Affiliation(s)
- An-Wen Chan
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kinwah Fung
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Peter C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - S Joseph Kim
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Lianne G Singer
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Respirology, University Health Network, Toronto, Ontario, Canada
| | - Nancy N Baxter
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Raed Alhusayen
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paula A Rochon
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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9
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Blomberg M, He SY, Harwood C, Arron ST, Demehri S, Green A, Asgari MM. Research gaps in the management and prevention of cutaneous squamous cell carcinoma in organ transplant recipients. Br J Dermatol 2017; 177:1225-1233. [PMID: 29086412 PMCID: PMC5711582 DOI: 10.1111/bjd.15950] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 12/13/2022]
Abstract
Although tremendous progress has been made in recent years in skin cancer care for organ transplant recipients, significant gaps remain in data-driven clinical guidelines, particularly for the treatment and prevention of cutaneous squamous cell carcinoma (cSCC), the most common malignancy among this population. In this review, we aim to summarize current knowledge around the management of cSCC and highlight the most significant gaps in knowledge that continue to pose challenges in the delivery of skin cancer care for organ transplant recipients. We suggest future directions for research that will bridge existing gaps and establish evidence-driven guidelines for primary prevention, screening and treatment of cSCC in this high-risk patient population.
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Affiliation(s)
- M Blomberg
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, U.S.A
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, U.S.A
| | - S Y He
- Department of Dermatology, Weill Cornell Medical College, New York, NY, U.S.A
| | - C Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - S T Arron
- Department of Dermatology, University of California, San Francisco, CA, U.S.A
| | - S Demehri
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, U.S.A
| | - A Green
- QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
- Cancer Research UK Manchester Institute, University of Manchester, Manchester, U.K
| | - M M Asgari
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, U.S.A
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, U.S.A
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