Incidence and clinical predictors of a subsequent nonmelanoma skin cancer in solid organ transplant recipients with a first nonmelanoma skin cancer: a multicenter cohort study.
OBJECTIVE
To compare the long-term risk of primary nonmelanoma skin cancer (NMSC) and the risk of subsequent NMSC in kidney and heart transplant recipients.


METHODS
Partially retrospective cohort study.


METHODS
Two Italian transplantation centers.


METHODS
The study included 1934 patients: 1476 renal transplant recipients and 458 heart transplant recipients.


METHODS
Cumulative incidences and risk factors of the first and subsequent NMSCs.


RESULTS
Two hundred patients developed a first NMSC after a median follow-up of 6.8 years after transplantation. The 3-year risk of the primary NMSC was 2.1%. Of the 200 patients with a primary NMSC, 91 (45.5%) had a second NMSC after a median follow-up after the first NMSC of 1.4 years (range, 3 months to 10 years). The 3-year risk of a second NMSC was 32.2%, and it was 49 times higher than that in patients with no previous NMSC. In a Cox proportional hazards regression model, age older than 50 years at the time of transplantation and male sex were significantly related to the first NMSC. Occurrence of the subsequent NMSC was not related to any risk factor considered, including sex, age at transplantation, type of transplanted organ, type of immunosuppressive therapy, histologic type of the first NMSC, and time since diagnosis of the first NMSC. Histologic type of the first NMSC strongly predicted the type of the subsequent NMSC.


CONCLUSIONS
Development of a first NMSC confers a high risk of a subsequent NMSC in transplant recipients. Intensive long-term dermatologic follow-up of these patients is advisable.
Section of Dermatology and Venereology, Department of Biomedical and Surgical Sciences, University of Verona, Piazzale A. Stefani 1, Verona, Italy. gianpaolo.tessari@azosp.vr.it
Gianpaolo
G
Tessari
Luigi
L
Naldi
Luigino
L
Boschiero
Francesco
F
Nacchia
Francesca
F
Fior
Alberto
A
Forni
Carlo
C
Rugiu
Giuseppe
G
Faggian
Fabrizia
F
Sassi
Eliana
E
Gotti
Roberto
R
Fiocchi
Giorgio
G
Talamini
Giampiero
G
Girolomoni
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors; D055815:Young Adult