Squamous cell carcinoma of the head and neck in solid organ transplant recipients

Abstract

Solid organ transplant recipients who are diagnosed with advanced head and neck cancer while receiving high doses of immunosuppressive drugs fare extremely poorly. High doses of immunosuppressive drugs, most notably prednisone, correlate significantly with advanced diagnosis of head and neck cancer and earlier death.

Oral squamous cell carcinoma: Review of prognostic and predictive factors

“…Patients under immunosuppressive therapy following solid organ transplant who developed OSCC fare worse than individuals with a less depressed immune system. 21 Additionally, there is an association between lower 5-year survival rates in patients with OSCC and evidence of immune depression. 22 These facts highlight the importance of immune response in tumor control and the potential value of cancer immunotherapy.…”

Noncutaneous head and neck cancer in solid organ transplant patients: Single center experience

“…Outcome studies in this specific population group are rare, but most experiences in the literature seem to note a worse outcome than in the general population. In general, the cancer progresses at a faster rate in transplant recipients and is more refractory to treatment, which explains the worse prognosis [4,15]. In addition, most often, patients are diagnosed at an advanced stage of HNC (stage III or IV), limiting the therapeutic options [4,6,12].…”

“…The impact of tobacco exposure and the synergistic carcinogenic effect of alcohol have long been demonstrated in the general population. In transplant patients, tobacco and/or alcohol also increase the risk of developing HNC (HR = 9.2; 95% CI 2.0-42.0; p = 0.004) [4,6,8,12].…”

“…Modifications of the immunosuppression treatment are often recommended [2,4,14]. Outcome studies in this specific population group are rare, but most experiences in the literature seem to note a worse outcome than in the general population.…”

“…The incidences for several tumors are much higher in transplant recipients when compared to the general population and increase with longer duration of follow-up [1,2]. Tumors in the head and neck area cover about 3.5-15% of all malignancies after transplantation [3][4][5]. A large part of these head and neck cancers (HNC) are squamous cell carcinomas (SCC) of the lip or oropharynx [6][7][8][9][10][11][12].…”