Cumulative incidence and risk factors for cutaneous squamous cell carcinoma metastases in organ transplant recipients: The Skin Care in Organ Transplant Patients in Europe-International Transplant Skin Cancer Collaborative metastases study, a prospective multicenter study.
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de Jong Estella, Genders Roel, Harwood Catherine A, Green Adèle C, Plasmeijer Elsemieke I, Proby Charlotte, Geissler Edward, Ferrándiz-Pulido Carla, Ducroux Emilie, Euvrard Sylvie, Geusau Alexandra, Jahn-Bassler Karin, Borik-Heil Liliane, Rácz Emõke, Nägeli Mirjam, Hofbauer Günther F L, Piaserico Stefano, Russo Irene, Mackintosh Lorna, Borges-Costa João, Angeliki-Gkini Maria, Zavattaro Elisa, Savoia Paola, Imko-Walszuk Beata, Dębska-Slizień Alicja, Garmyn Marjan, van Kelst Sofie, Ricar Jan, Cetkovska Petra, Matin Rubeta, Güleç Ayşe Tülin, Seçkin Deniz, Anene Chinedu Anthony, Oliveira Walmar R P, Rademaker Marius, Goeman Jelle, van Geloven Nan, Ruiz Emily, Murad Fadi, Karn Emily, Schmults Chrysalyne D, Bouwes Bavinck Jan Nico
Аннотация
METHODS: In a prospective cohort study, including 19 specialist dermatology outpatient clinics in 15 countries, patient and tumor characteristics were collected using standardized questionnaires when SOTRs presented with a new cSCC. After a minimum of 2 years of follow-up, relevant data for all SOTRs were collected. Cumulative incidence of metastases was calculated by the Aalen-Johansen estimator. Fine and Gray models were used to assess multiple risk factors for metastases.
RESULTS: Of 514 SOTRs who presented with 623 primary cSCCs, metastases developed in 37 with a 2-year patient-based cumulative incidence of 6.2%. Risk factors for metastases included location in the head and neck area, local recurrence, size > 2 cm, clinical ulceration, poor differentiation grade, perineural invasion, and deep invasion. A high-stage tumor that is also ulcerated showed the highest risk of metastasis, with a 2-year cumulative incidence of 46.2% (31.9%-68.4%).
CONCLUSIONS: SOTRs have a high risk of cSCC metastases and well-established clinical and histologic risk factors have been confirmed. High-stage, ulcerated cSCCs have the highest risk of metastasis.