背景:皮肤鳞状细胞癌(cSCC)是第二常见的皮肤肿瘤,发病率也在上升。虽然大多数cSCC预后良好,某些风险因素,尤其是免疫抑制,与较高的局部复发率(LR)有关,转移,预后不良。这项研究旨在评估实体器官移植受者(SOTR)中cSCC中LR和转移发展的危险因素,并将这些比率与免疫功能正常的患者进行比较。
方法:一项回顾性观察性研究包括来自科尔多瓦ReinaSofia大学医院的cSCC病例,西班牙,2002年至2019年。人口统计,临床,并收集组织病理学数据。分析局部复发和转移率,以及无进展生存期。进行单变量分析以确定SOTR的预后因素。
结果:在849例cSCC中,我们发现,与免疫功能正常个体相比,SOTR产生的肿瘤的局部复发率和转移率更高.然而,局部复发无显著差异,转移,两组间观察到无进展生存期.SOTR不良结局的危险因素包括肿瘤大小>2cm,深度>4毫米,和更高的克拉克水平。在随访期间,总共有34.4%的SOTR发生了第二个主要的cSCC。
结论:在我们的研究中,与免疫功能正常的患者相比,SOTR中的cSCCs的不良结局发生率无统计学差异.SOTR中cSCC的预后可能与其他肿瘤依赖性危险因素有关,而不是与免疫抑制状态本身有关。未来的研究需要完善风险分层和随访协议,以确保高风险cSCC病例的最佳管理,特别是在免疫抑制患者中。
BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most common cutaneous neoplasm, and its incidence is on the rise. While most cSCCs have an excellent prognosis, certain risk factors, especially immunosuppression, have been associated with higher rates of local recurrence (LR), metastasis, and poor prognosis. This
study aims to assess the risk factors for LR and metastasis development in cSCC among solid organ transplant recipients (SOTRs) and compare these rates with those in immunocompetent patients.
METHODS: A retrospective observational
study included cSCC cases from the University Hospital Reina Sofía in Córdoba, Spain, between 2002 and 2019. Demographic, clinical, and histopathological data were collected. Local recurrence and metastasis rates were analyzed, along with progression-free survival. Univariate analyses were performed to identify prognostic factors in SOTRs.
RESULTS: Among 849 cSCC cases, we found higher rates of local recurrence and metastasis in tumors developed by SOTRs compared to those in immunocompetent individuals. However, no significant differences in local recurrence, metastasis, or progression-free survival were observed between the two groups. Risk factors for adverse outcomes in SOTRs included tumor size > 2 cm, depth > 4 mm, and a higher Clark level. A total of 34.4% of SOTRs developed a second primary cSCC during the follow-up.
CONCLUSIONS: In our
study, cSCCs in SOTRs did not exhibit statistically significant differences in the rates of adverse outcomes compared to immunocompetent patients. The prognosis of cSCCs in SOTRs may be more related to other tumor-dependent risk factors than to the immunosuppression status itself. Future studies are needed to refine risk stratification and follow-up protocols to ensure the optimal management of high-risk cSCC cases, particularly among immunosuppressed patients.