NEW YORK (EGMN) –Recipients of pancreas transplants had a 19.6% cumulative incidence of developing skin cancer 10 years after transplant.

Moreover, those patients who developed squamous cell carcinoma (SCC) following transplant were found to have a 56% likelihood of developing a second SCC within 2 years, while patients who developed basal cell carcinoma (BCC) had a 36% chance of recurrence at 2 years.

The data, presented in a poster at the annual meeting of the American College of Mohs Surgery, show that “intensive educational and preventative strategies should be targeted at the pancreas transplant population,” according to Dr. Joshua Spanogle, a resident in the department of dermatology at the Mayo Clinic in Rochester, Minnesota.

Dr. Spanogle and his colleagues looked at 216 pancreas transplant recipients seen at a tertiary care center between 1996 and 2007. About half of the subjects were male, and the average age was 43 years, with a range of 21-71 years.

Overall, 107 patients received their pancreas transplant following a prior kidney transplant and were referred to as the “pancreas after kidney” group. A total of 67 patients received a pancreas transplant and did not receive a new kidney, and were known as the “pancreas transplant alone” group. Forty-two patients were in the “simultaneous pancreas-kidney” transplant group.

For all transplant recipients, the cumulative incidence of developing any skin cancer was 4.7% by 2 years. The cumulative incidence rose to 12.7% by 5 years and 19.6% by 10 years post transplant, Dr. Spanogle reported.

Looking at SCC specifically, the cumulative incidence was 2.8% at 2 years, 10.3% at 5 years, and 16.7% at 10 years. For BCC, the cumulative incidence rates were 2.4%, 7.8%, and 17.4% at 2, 5, and 10 years, respectively, he wrote.

Once patients were found to have an SCC, however, the chance of developing a second SCC within 2 years rose: There was a 56% cumulative incidence of subsequent SCC in that population. The risk for a second BCC after an initial post-transplant BCC diagnosis was also high, though less dramatic: The cumulative incidence for BCCs in the post-transplant, post-BCC-diagnosis population was 36%.

“None of the following variables were associated with an increased risk of skin cancer: type of transplant, induction therapy, initial immunosuppressive regimen, rejection status, or sex,” he pointed out. Only age was a significant predictor of the development of skin cancer, with a hazard ratio of 1.05.

Dr. Spanogle stated that he had no conflicts of interest to disclose.

Copyright (c) 2009 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

纽约(EGMN)——胰腺移植术的受者术后10年内出现皮肤癌的累积发生率高达19.6%。

 

而且，移植术后出现了鳞状细胞癌(SCC)的患者2年内出现第二处SCC的几率高达56%，而术后出现了基底细胞癌(BCC)的患者2年内癌症复发的几率也高达36%。

 

在美国莫斯外科学会2010年年会上，美国明尼苏达州罗切斯特市梅奥诊所皮肤科的住院医生Joshua Spanogle博士以壁报形式公布了以上研究数据。Spanogle博士说：“应针对胰腺移植人群制定严密的教育与预防策略。”

 

Spanogle博士及其同事对一家三级医疗中心于1996~2007年收治的216例胰腺移植术受者进行了评价。大约一半的患者为男性，平均年龄为43岁，年龄范围为21~71岁。

 

共有107例患者是在先接受了肾移植术后才接受的胰腺移植，这类患者被称为“肾移植后胰腺移植”组。共有67例患者接受了胰腺移植但没有接受肾移植，这类患者被称为“单纯胰腺移植”组。其余42例患者则被归为“胰腺-肾同时移植”组。

 

Spanogle博士报告称，在所有移植受者中，2年内出现任何一种类型的皮肤癌的累积发生率为4.7%。移植术后5年内该累积发生率上升至12.7%，10年内则高达19.6%。

 

Spanogle博士写道，就SCC而言，2年累积发生率为2.8%，5年为10.3%，10年为16.7%。就BCC而言，2年、5年和10年的累积发生率分别为2.4%、7.8%和17.4%。

 

但患者一旦发现出现了SCC，2年内出现第二处SCC的几率明显增加：在该人群中SCC复发的累积发生率为56%。移植术后首次确诊BCC后BCC再复发的风险也很高，尽管增幅不及SCC：在移植术后确诊患有BCC的人群中BCC复发的累积发生率为36%。

 

Spanogle博士指出：“以下指标均与皮肤癌风险增加无关：移植类型、诱导治疗、初始免疫抑制治疗方案、排异反应状态或性别。”只有年龄是皮肤癌发病的显著预测因子，危险比为1.05。

 

Spanogle博士声明无相关利益冲突可供披露。