Skin cancer after pancreas transplantation

• Published in: Journal of the American Academy of Dermatology 2012-10, Vol.67 (4), p.563-569
• Main Authors: Spanogle, Joshua P., MD, Kudva, Yogish C., MBBS, Dierkhising, Ross A., MS, Kremers, Walter K., PhD, Roenigk, Randall K., MD, Brewer, Jerry D., MD, Prieto, Mikel, MD, Otley, Clark C., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; basal cell carcinoma; Biological and medical sciences; Carcinoma, Basal Cell - epidemiology; Carcinoma, Basal Cell - immunology; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - immunology; Cohort Studies; Dermatology; Female; Humans; immunosuppression; Immunosuppression - adverse effects; Incidence; kidney transplantation; Male; Medical sciences; Middle Aged; pancreas transplantation; Pancreas Transplantation - statistics & numerical data; Postoperative Complications - epidemiology; Postoperative Complications - immunology; Predictive Value of Tests; Proportional Hazards Models; Retrospective Studies; Risk Factors; skin cancer; Skin Neoplasms - epidemiology; Skin Neoplasms - immunology; squamous cell carcinoma; Transplantation, Homologous; Tumor Burden; Tumors of the skin and soft tissue. Premalignant lesions; Young Adult
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2011.11.939

Background Skin cancer in patients who have undergone pancreas transplantation (PT) has not been extensively characterized. Objective We sought to describe the incidence, tumor burden, and risk factors for skin cancer in PT recipients at Mayo Clinic from 1998 through 2006. Methods A retrospective study was performed by analyzing outcomes among a cohort of pancreas allograft recipients at Mayo Clinic between 1998 and 2006. Results Among 216 allogeneic PT recipients at 2, 5, and 10 years posttransplantation, the cumulative incidence of any skin cancer was 4.7%, 12.7%, and 19.6%; the cumulative incidence of squamous cell carcinoma was 2.8%, 10.3%, and 16.7%; and the cumulative incidence of basal cell carcinoma was 2.4%, 7.8%, and 17.4%, respectively. The cumulative incidence of a second squamous cell carcinoma developing was 56% at 2 years; the cumulative incidence of a second basal cell carcinoma developing was 36% at 2 years. Of the risk factors examined, only age and having a skin cancer before transplantation were predictive of skin cancer development. Limitations This was a retrospective study. Results from a large tertiary center may not be generalizable. Conclusions Nonmelanoma skin cancers commonly occur in recipients of PT, and those patients who have a history of nonmelanoma skin cancer have a very high likelihood of further skin cancer development.