Aggressive Squamous Cell Carcinoma in Organ Transplant Recipients
Aggressive Squamous Cell Carcinoma in Organ Transplant Recipients
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DOI：
10.1001/jamadermatol.2018.4406
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发表时间：
2019-01-01
期刊：
影响因子：
10.9
通讯作者：
Hofbauer, Guenther F. L.
中科院分区：
文献类型：
--
作者：
Lanz, Joana;Bavinck, Jan Nico Bouwes;Hofbauer, Guenther F. L.
目的探讨实体器官移植患者侵袭性鳞状细胞癌的临床病理特点及相关因素。方法对51例实体器官移植患者行实体器官移植后发现侵袭性鳞状细胞癌的临床病理特征及相关因素进行分析。研究人员在2005年7月18日至2015年1月1日期间完成了标准问卷调查。分析2016年2月22日至2016年7月12日的数据。结果51名参与者中，男性43名，女性8名，移植时年龄中位数为51岁(19-71岁)，诊断为侵袭性鳞癌时年龄中位数为62岁(36-77岁)。侵袭性鳞癌主要分布在面部(34例(67%))和头皮(6例(12%))，其次是上肢(6例(12%))。低分化肿瘤21例(41%)，肿瘤直径中位数18.0 mm(4.0~64.0 mm)，肿瘤深度中位数6.2 mm(1.0~20.0 mm)。20例(39%)患者有神经侵袭，23例(45%)局部复发。5年总生存率为23%，5年疾病特异性生存率为30.5%。结论本病例的解剖部位、分化程度、肿瘤直径、肿瘤深度和神经侵袭是实体器官移植受者侵袭性鳞癌的重要危险因素。
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.