Incidence and prediction of nonmelanoma skin cancer post-renal transplantation: a prospective study in Queensland, Australia.

Nonmelanoma skin cancer (NMSC) is a significant clinical problem after renal transplantation, particularly in areas of high UV light exposure. A single-center prospective study of a population of Queensland renal transplant recipients was performed with the aims of: (1) establishing NMSC incidence and tumor accrual post-renal transplantation, and (2) developing a clinically derived predictive index to identify transplant recipients at greatest risk. Three hundred ten of 398 transplant recipients (78%) who underwent baseline assessment between July 1999 and April 2000 were reassessed a mean of 18 +/- 3.5 (SD) months later. A structured interview, full skin examination, biopsy of suspicious lesions, and review of medical and pathological records were used to determine the number and types of NMSC arising between the two assessments. Incidence (percentage of the population developing NMSC per year) and tumor accrual (number of tumors per person per year) were calculated. A clinically derived predictive index was generated using stepwise logistic regression models. Overall NMSC incidence was 28.1% and increased with duration of immunosuppression therapy: 18.8%, 24.8%, 33.3%, and 47.1% at less than 5, 5 to 10, 10 to 20, and greater than 20 years of immunosuppression therapy, respectively. Mean NMSC accrual was 1.85 +/- 3.84 tumors/person/y, increasing to 3.35 +/- 4.29 tumors/person/y after 20 years of immunosuppression therapy. Renal transplant recipients were stratified into categories of high and low NMSC risk by using predictive indices. Clinically derived predictive indices can allow NMSC risk stratification of an Australian transplant population and may provide an evidence-based and cost-effective approach to developing a targeted clinical NMSC surveillance program.

Carroll RP ，Ramsay HM ，Fryer AA ，Hawley CM ，Nicol DL ，Harden PN ... -  《-》

A population-based study of skin cancer incidence and prevalence in renal transplant recipients.

Moloney FJ ，Comber H ，O'Lorcain P ，O'Kelly P ，Conlon PJ ，Murphy GM ... -  《BRITISH JOURNAL OF DERMATOLOGY》

First and subsequent nonmelanoma skin cancers: incidence and predictors in a population of New Zealand renal transplant recipients.

Mackenzie KA ，Wells JE ，Lynn KL ，Simcock JW ，Robinson BA ，Roake JA ，Currie MJ ... -  《-》

Predicting risk of nonmelanoma skin cancer and premalignant skin lesions in renal transplant recipients.

Urwin HR ，Jones PW ，Harden PN ，Ramsay HM ，Hawley CM ，Nicol DL ，Fryer AA ... -  《-》

Nonmelanoma skin cancer after renal transplantation: a single-center experience in 1736 transplantations.

Renal transplantation is associated with an increased incidence of nonmela-noma skin cancer (NMSC) caused by immunosuppression. Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), the two major histological types of NMSC, exhibit more aggressive biological and clinical courses in renal transplant recipients (RTRs), with higher rates of recurrence and mortality than in the general population. We retrospectively analyzed our experience of NMSC in 1736 renal transplantations performed over a 25-year period. All cases of skin cancer after renal transplantation were included except those of skin cancer resulting from melanoma and mesenchymal skin tumors. In our series, the overall incidence of NMSC after transplantation was 2.2% (n = 39), and SCC represented the most frequent skin malignancy (64.1%), followed by BCC (17.9%), Bowen's disease (10.2%), basosquamous carcinoma (5.1%), and a rare case of invasive sebaceous carcinoma (2.6%). A shift to newer immunosuppressive regimens after the initial diagnosis of NMSC had been implemented in eight cases (20.5%). The recurrence rate after initial treatment was 41% (n = 16), and distant metastatic disease was diagnosed in 15.4% (n = 6) of NMSC patients. The NMSC-specific mortality rate was 25.6% (n = 10). Nonmelanoma skin cancer remains a significant source of morbidity and mortality in RTRs, and post-transplant surveillance should be increased.

Zavos G ，Karidis NP ，Tsourouflis G ，Bokos J ，Diles K ，Sotirchos G ，Theodoropoulou E ，Kostakis A ... -  《-》