Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021
PurposePosttransplant skin cancer is the most common malignancy after patients have undergone renal transplantation. Through comprehensive observation with a large sample size nationwide, understanding the risk factors and outcome of posttransplant skin cancer will help to develop appropriate patien...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1017498/full |
| _version_ | 1811189700536303616 |
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| author | Xiaowei Hao Xiaowei Hao Wenhui Lai Wenhui Lai Xinze Xia Xinze Xia Junnan Xu Yangyang Wu Chao Lv Qingyang Meng Kaikai Lv Shuai Huang Shuai Huang Zhenjun Luo Zhenjun Luo Jun Dong Qing Yuan |
| author_facet | Xiaowei Hao Xiaowei Hao Wenhui Lai Wenhui Lai Xinze Xia Xinze Xia Junnan Xu Yangyang Wu Chao Lv Qingyang Meng Kaikai Lv Shuai Huang Shuai Huang Zhenjun Luo Zhenjun Luo Jun Dong Qing Yuan |
| author_sort | Xiaowei Hao |
| collection | DOAJ |
| description | PurposePosttransplant skin cancer is the most common malignancy after patients have undergone renal transplantation. Through comprehensive observation with a large sample size nationwide, understanding the risk factors and outcome of posttransplant skin cancer will help to develop appropriate patient surveillance and disease prevention strategies.Materials and methodsThis retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes, including patient survival and graft survival of recipients, were compared. Risk factors for posttransplant skin cancer, cancer onset momentum, and mortality were determined.ResultsA total of 199,564 renal transplant recipients were included. After renal transplantation, 7,334 (3.68%), 6,093 (3.05%), and 936 (0.47%) were diagnosed with squamous cell carcinoma, basal cell carcinoma, and melanoma, respectively. Skin cancer was the major cause of death (squamous cell carcinoma: 23.8%, basal cell carcinoma: 18%, and melanoma: 41.6%). Five-year survival rates ranked from best to worst were as follows: basal cell carcinoma (96.7 [95% confidence interval: 96.3–97.2]%), squamous cell carcinoma (94.1 [93.5–94.6]%), melanoma (89.7 [87.7–91.6]%), and cancer-free (87.4 [87.2–87.5]%) (p < 0.001 for all except melanoma vs. cancer-free, p = 0.534). Regarding graft survival, death-censored graft survival, posttransplant skin cancer, and melanoma were significantly better than the cancer-free group (p < 0.001). Independent risk factors for developing posttransplant skin cancer included older age, male sex, Caucasian race, pretransplant malignancy, polycystic kidney disease-induced end-stage renal disease (ESRD), retransplantation, private health insurance, T-cell depletion induction, and tacrolimus/mycophenolic acid use. Caucasian race and pretransplant malignancy were independent risk factors for posttransplant skin cancer onset momentum. Male sex, Caucasian race, pretransplant malignancy, hypertension- or diabetes-induced ESRD, retransplantation, diabetes history, deceased donor, cyclosporin, and mTOR inhibitor use were independent risk factors for posttransplant skin cancer mortality.ConclusionAlthough posttransplant skin cancer is a major cause of recipient death, information regarding its impact on patient and graft survival is limited. Given the differences regarding risk factors for posttransplant skin cancer incidence, onset momentum, and mortality, personalized approaches to screening may be appropriate to address the complex issues encountered by kidney transplant recipients. |
| first_indexed | 2024-04-11T14:38:56Z |
| format | Article |
| id | doaj.art-d9aa7ef2aa6b46209fc3bde935696583 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T14:38:56Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-d9aa7ef2aa6b46209fc3bde9356965832022-12-22T04:18:11ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-11-011210.3389/fonc.2022.10174981017498Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021Xiaowei Hao0Xiaowei Hao1Wenhui Lai2Wenhui Lai3Xinze Xia4Xinze Xia5Junnan Xu6Yangyang Wu7Chao Lv8Qingyang Meng9Kaikai Lv10Shuai Huang11Shuai Huang12Zhenjun Luo13Zhenjun Luo14Jun Dong15Qing Yuan16Department of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, No.971 Hospital of PLA Navy, Tsingtao, Shandong, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Postgraduate, Hebei North University, Zhangjiakou, Hebei, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Postgraduate, Hebei North University, Zhangjiakou, Hebei, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaAffiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaDepartment of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing, ChinaPurposePosttransplant skin cancer is the most common malignancy after patients have undergone renal transplantation. Through comprehensive observation with a large sample size nationwide, understanding the risk factors and outcome of posttransplant skin cancer will help to develop appropriate patient surveillance and disease prevention strategies.Materials and methodsThis retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes, including patient survival and graft survival of recipients, were compared. Risk factors for posttransplant skin cancer, cancer onset momentum, and mortality were determined.ResultsA total of 199,564 renal transplant recipients were included. After renal transplantation, 7,334 (3.68%), 6,093 (3.05%), and 936 (0.47%) were diagnosed with squamous cell carcinoma, basal cell carcinoma, and melanoma, respectively. Skin cancer was the major cause of death (squamous cell carcinoma: 23.8%, basal cell carcinoma: 18%, and melanoma: 41.6%). Five-year survival rates ranked from best to worst were as follows: basal cell carcinoma (96.7 [95% confidence interval: 96.3–97.2]%), squamous cell carcinoma (94.1 [93.5–94.6]%), melanoma (89.7 [87.7–91.6]%), and cancer-free (87.4 [87.2–87.5]%) (p < 0.001 for all except melanoma vs. cancer-free, p = 0.534). Regarding graft survival, death-censored graft survival, posttransplant skin cancer, and melanoma were significantly better than the cancer-free group (p < 0.001). Independent risk factors for developing posttransplant skin cancer included older age, male sex, Caucasian race, pretransplant malignancy, polycystic kidney disease-induced end-stage renal disease (ESRD), retransplantation, private health insurance, T-cell depletion induction, and tacrolimus/mycophenolic acid use. Caucasian race and pretransplant malignancy were independent risk factors for posttransplant skin cancer onset momentum. Male sex, Caucasian race, pretransplant malignancy, hypertension- or diabetes-induced ESRD, retransplantation, diabetes history, deceased donor, cyclosporin, and mTOR inhibitor use were independent risk factors for posttransplant skin cancer mortality.ConclusionAlthough posttransplant skin cancer is a major cause of recipient death, information regarding its impact on patient and graft survival is limited. Given the differences regarding risk factors for posttransplant skin cancer incidence, onset momentum, and mortality, personalized approaches to screening may be appropriate to address the complex issues encountered by kidney transplant recipients.https://www.frontiersin.org/articles/10.3389/fonc.2022.1017498/fullskin cancerrenal transplantation (RT)end stage renal disease (ESRD)UNOS/OPTNrisk factors |
| spellingShingle | Xiaowei Hao Xiaowei Hao Wenhui Lai Wenhui Lai Xinze Xia Xinze Xia Junnan Xu Yangyang Wu Chao Lv Qingyang Meng Kaikai Lv Shuai Huang Shuai Huang Zhenjun Luo Zhenjun Luo Jun Dong Qing Yuan Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 Frontiers in Oncology skin cancer renal transplantation (RT) end stage renal disease (ESRD) UNOS/OPTN risk factors |
| title | Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 |
| title_full | Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 |
| title_fullStr | Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 |
| title_full_unstemmed | Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 |
| title_short | Skin cancer outcomes and risk factors in renal transplant recipients: Analysis of organ procurement and transplantation network data from 2000 to 2021 |
| title_sort | skin cancer outcomes and risk factors in renal transplant recipients analysis of organ procurement and transplantation network data from 2000 to 2021 |
| topic | skin cancer renal transplantation (RT) end stage renal disease (ESRD) UNOS/OPTN risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1017498/full |
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