News

Pancreas Transplantation Ups Skin Cancer Risk : The cumulative incidence of skin cancer 10 years after the transplant is nearly 20%.


 

Major Finding: Pancreas transplant recipients had a cumulative incidence of subsequent skin cancer of 4.7% at 2 years, 12.7% by 5 years, and 19.6% by 10 years after transplant.

Data Source: A single-center chart review of patients seen at a tertiary care center from 1996 to 2007, presented in a poster.

Disclosures: Dr. Spanogle stated that he had no relevant financial conflicts to disclose.

NEW YORK — Recipients of pancreas transplants had a 19.6% cumulative incidence of developing skin cancer 10 years after transplant.

Moreover, those patients who developed squamous cell carcinoma (SCC) following transplant were found to have a 56% likelihood of developing a second SCC within 2 years, while patients who developed basal cell carcinoma (BCC) had a 36% chance of recurrence at 2 years.

The data, presented in a poster at the meeting, show that “intensive educational and preventative strategies should be targeted at the pancreas transplant population,” according to Dr. Joshua Spanogle, a resident in the department of dermatology at the Mayo Clinic in Rochester, Minn.

Dr. Spanogle and his colleagues looked at 216 pancreas transplant recipients seen at a tertiary care center between 1996 and 2007. About half of the subjects were male, and the average age was 43 years, with a range of 21–71 years.

Overall, 107 patients in the study received their pancreas transplant following a prior kidney transplant and were referred to as the “pancreas after kidney” group.

A total of 67 patients received a pancreas transplant and did not receive a new kidney, and were known as the “pancreas transplant alone” group. Forty-two patients were in the “simultaneous pancreas-kidney” transplant group.

For all transplant recipients, the cumulative incidence of developing any skin cancer was 4.7% by 2 years. The cumulative incidence rose to 12.7% by 5 years and 19.6% by 10 years post transplant, Dr. Spanogle reported at the meeting.

Looking at SCC specifically, the cumulative incidence was 2.8% at 2 years, 10.3% at 5 years, and 16.7% at 10 years. For BCC, the cumulative incidence rates were 2.4%, 7.8%, and 17.4% at 2, 5, and 10 years, respectively, he wrote.

Once patients were found to have an SCC, however, the chance of developing a second SCC within 2 years rose: There was a 56% cumulative incidence of subsequent SCC in that population.

The risk for a second BCC after an initial posttransplant BCC diagnosis was also high, though less dramatic: The cumulative incidence for BCCs in the posttransplant, post–BCC-diagnosis population was 36%.

“None of the following variables were associated with an increased risk of skin cancer: type of transplant, induction therapy, initial immunosuppressive regimen, rejection status, or sex,” he pointed out.

Only age was a significant predictor of the development of skin cancer, with a hazard ratio of 1.05, according to the investigation findings.

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