Guidelines for the Management of Squamous Cell Carcinoma in Organ Transplant Recipients

Abstract

BACKGROUND. Solid-organ transplant recipients have a high incidence of cutaneous squamous cell carcinoma (SCC) and often develop multiple and aggressive tumors. There are few published studies or reviews, which provide guidance to the clinician in the treatment of these patients. OBJECTIVE. The objective was to develop useful clinical guidelines for the treatment of skin cancer in organ transplant recipients (OTRs). METHODS. The members of the Guidelines Committee of the International Transplant-Skin Cancer Collaborative (ITSCC) carried out a computerized search utilizing the databases of the National Library of Medicine for reports in the literature on SCC in OTRs. These reports were collectively examined by the group and combined with experiences from the members' clinical practices in the development of the guidelines. RESULTS. More than 300 articles relating to SCC in OTRs were reviewed. In general, reports concerning the prevention and treatment of SCC in OTRs are of individual cases or small case series. They are retrospective in nature, statistically nonrigorous, and lack the complete epidemiologic data necessary to derive definitive conclusions. Combining these studies and collective clinical experience, however, is at present the best available method for devising guidelines for the treatment of SCC in OTRs. CONCLUSION. Guidelines developed for the treatment of skin cancer in OTRs, supported by the best available data and collective clinical experience, may assist in the management of OTRs with SCC. The development of clinical pathways and complete documentation with rigorous prospective study is necessary to improve and refine future guideline development.

Management of Non-Melanoma Skin Cancer in Solid Organ Transplant Recipients

“…Patients with low risk NMSC should be checked every 6 months, those with multiple AK or a previous NMSC every 3-6 months, and those with high-risk SCC every 3 months. Patients with a suspected skin lesion should be promptly referred to a dermatologist, and ifnecessary, suspected lesions should be biopsied or removed (14,15). Surgical therapy for NMSC should be performed according to current guidelines, and clear margins on histologic examination should be obtained (16).…”

Treatment Recommendations among Radiation Oncologists in the Treatment of Cutaneous Squamous Cell Carcinoma with Perineural Invasion

“…Iatrogenic immunosuppression in organ transplant recipients is a major risk factor for morbidity and mortality in CSCC [4] [5] [22] [44]. Deep invasion has also been described as a poor prognostic factor in studies based on major prospective databases [5] [6].…”

Piktybiniai Odos Navikai Recipientams Po Organų Transplantacijos

“…Spindulinė terapija. Spindulinė terapija kaip adjuvantinis gydymo metodas gali būti taikoma, pvz., PLK gydymui, kai neįmanomas visiškas naviko pašalinimas arba yra perineuralinis plitimas [85].…”