UASSIGNED:移植后皮肤癌是患者接受肾移植后最常见的恶性肿瘤。通过在全国范围内进行大样本量的综合观察,了解移植后皮肤癌的危险因素和结果将有助于制定适当的患者监测和疾病预防策略。
UNASSIGNED:这项基于人群的回顾性队列研究基于2021年3月发布的器官采购和移植网络数据。特点和结果,包括病人的存活和移植受体的存活,进行了比较。移植后皮肤癌的危险因素,癌症发作动量,并确定了死亡率。
UNASSIGNED:共纳入199,564例肾移植受者。肾移植后,7,334(3.68%),6,093(3.05%),936例(0.47%)被诊断为鳞状细胞癌,基底细胞癌,和黑色素瘤,分别。皮肤癌是死亡的主要原因(鳞状细胞癌:23.8%,基底细胞癌:18%,黑色素瘤:41.6%)。五年生存率从最好到最差排序如下:基底细胞癌(96.7[95%置信区间:96.3-97.2]%),鳞状细胞癌(94.1[93.5-94.6]%),黑色素瘤(89.7[87.7-91.6]%),和无癌(87.4[87.2-87.5]%)(除黑色素瘤与无癌,p=0.534)。关于移植物存活,死亡审查的移植物存活,移植后皮肤癌,和黑色素瘤明显优于无癌组(p<0.001)。发生移植后皮肤癌的独立危险因素包括年龄,男性,高加索种族,移植前恶性肿瘤,多囊肾病引起的终末期肾病(ESRD),再移植,私人医疗保险,T细胞耗竭诱导,和他克莫司/霉酚酸使用。高加索种族和移植前恶性肿瘤是移植后皮肤癌发病动力的独立危险因素。男性,高加索种族,移植前恶性肿瘤,高血压或糖尿病诱导的ESRD,再移植,糖尿病史,已故捐献者,环孢菌素,mTOR抑制剂的使用是移植后皮肤癌死亡率的独立危险因素。
未经授权:尽管移植后皮肤癌是受者死亡的主要原因,关于其对患者和移植物存活的影响的信息是有限的。考虑到移植后皮肤癌发病率的危险因素的差异,发作动量,和死亡率,个性化筛查方法可能适用于解决肾移植受者遇到的复杂问题.
UNASSIGNED: Posttransplant skin cancer is the most common malignancy after patients have undergone renal transplantation. Through comprehensive observation with a large sample size nationwide, understanding the risk factors and outcome of posttransplant skin cancer will help to develop appropriate patient surveillance and disease prevention strategies.
UNASSIGNED: This retrospective population-based cohort study was based on Organ Procurement and Transplantation Network data released in March 2021. Characteristics and outcomes, including patient survival and graft survival of recipients, were compared. Risk factors for posttransplant skin cancer, cancer onset momentum, and mortality were determined.
UNASSIGNED: A total of 199,564 renal transplant recipients were included. After renal transplantation, 7,334 (3.68%), 6,093 (3.05%), and 936 (0.47%) were diagnosed with squamous cell carcinoma, basal cell carcinoma, and melanoma, respectively. Skin cancer was the major cause of death (squamous cell carcinoma: 23.8%, basal cell carcinoma: 18%, and melanoma: 41.6%). Five-year survival rates ranked from best to worst were as follows: basal cell carcinoma (96.7 [95% confidence interval: 96.3-97.2]%), squamous cell carcinoma (94.1 [93.5-94.6]%), melanoma (89.7 [87.7-91.6]%), and cancer-free (87.4 [87.2-87.5]%) (p < 0.001 for all except melanoma vs. cancer-free, p = 0.534). Regarding graft survival, death-censored graft survival, posttransplant skin cancer, and melanoma were significantly better than the cancer-free group (p < 0.001). Independent risk factors for developing posttransplant skin cancer included older age, male sex, Caucasian race, pretransplant malignancy, polycystic kidney disease-induced end-stage renal disease (ESRD), retransplantation, private health insurance, T-cell depletion induction, and tacrolimus/mycophenolic acid use. Caucasian race and pretransplant malignancy were independent risk factors for posttransplant skin cancer onset momentum. Male sex, Caucasian race, pretransplant malignancy, hypertension- or diabetes-induced ESRD, retransplantation, diabetes history, deceased donor, cyclosporin, and mTOR inhibitor use were independent risk factors for posttransplant skin cancer mortality.
UNASSIGNED: Although posttransplant skin cancer is a major cause of recipient death, information regarding its impact on patient and graft survival is limited. Given the differences regarding risk factors for posttransplant skin cancer incidence, onset momentum, and mortality, personalized approaches to screening may be appropriate to address the complex issues encountered by kidney transplant recipients.