Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate

Bordea, Cristina; Wojnarowska, Fenella; Millard, P. R.; Doll, H; Welsh, Ken I.; Morris, Peter J.

doi:10.1097/01.tp.0000108491.62935.df

Cited by 218 publications

(180 citation statements)

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“…[1][2][3] The etiology of Merkel cell carcinoma may be multifactorial. The exposure to ultraviolet radiation, [4][5][6] as well as immunosuppression [7][8][9][10] is associated with Merkel cell carcinoma. Recently, a novel polyomavirus, named Merkel cell polyomavirus, was identified in Merkel cell carcinoma tumor tissue, suggesting that a viral infection might also be an etiological factor.…”

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confidence: 99%

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma

et al. 2010

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This study investigated vascular and especially lymphovascular invasion in primary Merkel cell carcinoma and its value as a prognostic factor. Paraffin-embedded blocks prepared from tumor samples obtained from126 patients diagnosed with Merkel cell carcinoma in 1979-2004 were immunohistochemically stained using antibodies CD31 and D2-40 to detect intravascular tumor emboli. This finding was compared with the clinical data and the disease outcome. Intravascular tumor cells were observed in 117 (93%) of the samples. The majority, 83 (66%), showed only lymphovascular invasion. Only blood vascular invasion was seen in four (3%) samples. In all, 30 (24%) samples demonstrated both lymphovascular invasion and blood vascular invasion. In only nine (7%) samples, there was no invasion within the vascular structures. The tumors lacking invasion were significantly smaller (Po0.01 and a ¼ 0.050) than those with vascular invasion, although lymphovascular invasion was observed even in the smallest tumor (0.3 cm) of this study. Already in the early stages of the disease, Merkel cell carcinoma seems to have the capacity to penetrate vessel walls. Our finding of the high frequency of lymphovascular invasion might therefore explain the extremely aggressive clinical behavior of Merkel cell carcinoma. This may support the role of sentinel node biopsy even in the case of very small primary Merkel cell carcinoma tumors.

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confidence: 99%

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma

et al. 2010

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“…It has been well documented that patients with organ transplants that are maintained with immunotherapy are very prone to skin cancer (e.g. Bordea et al, 2004). Immunosuppression by solar-simulated UV in men has been observed at doses three times lower than those required for immunosuppression in women (Damian et al, 2008).…”

Section: Immune Response and Photoadaptationmentioning

confidence: 99%

Solar and ultraviolet radiation

Gies¹,

Roy²,

Udelhofen

2004

Cancer Prevention — Cancer Causes

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“…In fact, in the next 20 years, cancer is expected to be one of the most important causes of death among this group of patients. 2 Several factors have been associated with the increased incidence of de novo malignancies among transplant recipients, namely sun exposure, 3 extent and duration of immunosuppression, 4,5 concomitant viral infection, 6 and longer pretransplantation dialysis periods. 7 Among the risk factors associated with de novo malignancies in this setting, the advanced age of the transplanted population and the long-term immunosuppressive therapy are important contributors to an increased number of malignancies.…”

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confidence: 99%

The Incidence of Cancer and Potential Role of Sirolimus Immunosuppression Conversion on Mortality Among a Single-Center Renal Transplantation Cohort of 1,816 Patients

Branco

Cavadas

Osório

et al. 2011

Transplantation Proceedings

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Introduction. The chronic use of immunosuppressive drugs in renal transplant recipients increases the risk of developing de novo malignancies. Herein we analyze the incidence of de novo tumors and the potential role of sirolimus to improve cancer-specific survival among a cohort at a single center.Methods. This retrospective analysis of our 1,816 patients allografted between January 1983 and December 2009 sought subjects who developed de novo tumors. Epidemiological and clinical data were examined using Mann-Whitney and Pearson's chi-square or Fisher exact tests for statistical comparisons of continuous and categorical variables, respectively. Kaplan-Meier survival curves were used to determine cancer-specific survival according to type of neoplasia and immunosuppressive regimen, namely, conversion to sirolimus. Results. One hundred patients (5.5%) were diagnosed with a de novo malignancy. The 110 different cancers were diagnosed at a median interval of 73 months after kidney transplantation. The overall cancer-specific survivals at 1 and 5 years after cancer diagnosis were 87.0% and 76.9%, respectively. The 15 patients converted to sirolimus showed no difference in survival. Conclusion. The observed frequencies of cancer in our center are consistent with the literature. Among our cohort, sirolimus did not significantly impact survival among subjects who had de novo malignancies.

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Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate

Cited by 218 publications

References 20 publications

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma

Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma

Solar and ultraviolet radiation

The Incidence of Cancer and Potential Role of Sirolimus Immunosuppression Conversion on Mortality Among a Single-Center Renal Transplantation Cohort of 1,816 Patients

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