Increased risk of squamous-cell carcinoma in simultaneous pancreas kidney transplant recipients compared with kidney transplant recipients.
The purpose of this study was to ascertain the risk of non-melanocytic skin cancer (NMSC) in simultaneous pancreas kidney transplant recipients (SPKTRs) compared with kidney transplant recipients (KTRs) in relation to other potential risk factors of skin cancer. In a cohort study, 208 SPKTRs were compared with 1,111 KTRs who were transplanted during the same time period. The effects of age, sex, country of origin, time period after transplantation, HLA matching, immunosuppressive regimen, and rejection treatments on the risk of NMSC were investigated in multivariable Cox's proportional hazard models. In SPKTRs, the incidence of NMSC increased from 19 to 36%, respectively, 10 and 15 years after transplantation, which was significantly higher compared with that in KTRs (6 and 10%, respectively). After adjustment for age and sex, SPKTRs had a 6.2 (3.0-12.8) increased risk of squamous-cell carcinoma (SCC) compared with KTRs. An additional adjustment for maintenance immunosuppression decreased the hazard ratio to 3.1 (1.3, 7.2), which indicates partial confounding by the immunosuppressive regimen. Adjustment for induction and rejection therapy or HLA mismatching did not change the hazard ratio significantly. SPKTRs have an increased risk of SCC compared with KTRs, despite partial confounding by the immunosuppressive regimen.
Wisgerhof
Hermina C
HC
Department of Dermatology, B1-Q, Leiden University Medical Center, PO Box 9600, Leiden 2300 RC, The Netherlands. h.c.wisgerhof@lumc.nl
van der Boog
Paul J M
PJ
de Fijter
Johan W
JW
Wolterbeek
Ron
R
Haasnoot
Geert W
GW
Claas
Frans H J
FH
Willemze
Rein
R
Bouwes Bavinck
Jan N
JN
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016035:Pancreas Transplantation / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000276:immunology
D007166:Immunosuppressive Agents