Risk factors for nonmelanoma skin cancer in renal transplant recipients: a case-control study from a reference outpatient clinic in Southeast Brazil.

Nonmelanoma skin cancer (NMSC) is the most common tumor in humans, and its incidence increases among renal transplant recipients (RTRs). The aims of this study were to characterize the RTRs with NMSC, to identify risk factors, and to calculate the probability of this tumor in this population. This was a hospital-based case-control study. Epidemiological and clinical variables were evaluated. Hierarchical logistic regression was used, and a mathematical model was built. In total, 245 subjects were included. Possible associations were identified using a univariate analysis. Multivariate analysis identified risk factors with respective odds ratios and confidence intervals (95% CI): males 2.5 (1.3-4.7), age over 50 years 5.4 (2.3-12.9), Fitzpatrick's skin phototypes I-III 3.7 (1.6-8.7), occupational sun exposure 4.1 (2.1-8.1), timetable of recreational sun exposure all day 3.0 (1.4-6.1), and duration of transplantation (80 months or more) 3.3 (1.6-6.5). The Hosmer-Lemeshow test and the receiver operating characteristics curve showed a strong fit and accuracy, respectively. The probability of an NMSC ranged from less than 1 to 92.5%. This study characterized the RTRs with NMSC and identified risk factors. The multivariate analysis by hierarchical logistic regression proved to be a useful tool and allowed for the determination of the probability of NMSC in this population.

Ferreira FR ，Ogawa MM ，Nascimento LF ，Tomimori J ... -  《-》

[Patients with solid organ transplantation and skin cancer: determination of risk factors with emphasis in photoexposure and immunosuppressive regimen. Experience in a third level hospital].

Rodríguez-Acosta ED ，Calva-Mercado JJ ，Alberú-Gómez J ，Vilatoba-Chapa M ，Domínguez-Cherit J ... -  《Gaceta Medica de Mexico》

Epidemiology and clinical evolution of non-melanoma skin cancer in renal transplant recipients: a single-center experience in São Paulo, Brazil.

Non-melanoma skin cancer (NMSC) is very common among renal transplant recipients (RTRs) as a result of the immunosuppressed status of these patients and other factors. Few studies have examined the clinical characteristics and evolution of NMSC in RTRs in tropical countries. The aim of this study was to characterize the epidemiology and clinical evolution of NMSC in RTRs. We conducted a retrospective study including 68 RTRs with NMSC diagnosed from July 2004 to December 2009 with a minimum follow-up of three years. We analyzed demographic and transplant- and NMSC-related data. The mean age of patients at the first diagnosis of NMSC was 51 years (range: 29-71 years). Most first diagnoses occurred within nine years post-transplant. The majority of patients (n = 48) had Fitzpatrick skin phototype II, although NMSC was also observed in those with skin phototypes III and IV. Forty-six (67.6%) RTRs had received a kidney from a living donor. Fifty-five (80.9%) RTRs had received cytotoxic immunosuppressives, 51 (75.0%) had received calcineurin inhibitors, and two (2.9%) had received mTOR inhibitors. Most of the RTRs developed about eight NMSC lesions, but up to 25 NMSC lesions were diagnosed in one patient. Most lesions (67.6%) were located on sun-exposed areas. Squamous cell carcinoma (SCC) represented the predominant tumor type, accounting for 70.6% of all tumors, whereas basal cell carcinoma accounted for 29.4% of all tumors. Invasive SCC predominated over in situ SCC. Finally, 48.5% of patients had a previous history of viral warts. Long-term use of immunosuppressive therapy increases the risk for tumor occurrence. Multiple NMSC tumors can develop in patients in tropical countries, even in patients with a high skin phototype. Therefore, RTRs should understand the high risk for the development of malignant tumors and should be properly informed about the prevention and treatment of NMSC.

Hayashida MZ ，Fernandes VM ，Fernandes DR ，Ogawa MM ，Tomimori J ... -  《-》

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 ... -  《-》

Risk factors for non-melanoma skin cancer in kidney transplant patients in a Spanish population in the Mediterranean region.

Bernat García J ，Morales Suárez-Varela M ，Vilata JJ ，Marquina A ，Pallardó L ，Crespo J ... -  《-》