Melanoma in a cohort of organ transplant recipients: Experience from a dedicated transplant dermatology clinic in Victoria, Australia - 20/02/20
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Abstract |
Background |
There is limited information on the profile of melanomas diagnosed in a specialist transplant dermatology clinic.
Objective |
To describe the incidence and characteristics of incident primary melanomas in a cohort of organ transplant recipients (OTRs) attending a specialized transplant dermatology clinic and determine the number of pigmented lesions needed to excise for every melanoma diagnosed.
Methods |
A retrospective study of 327 OTRs monitored by an Australian clinic during a 10-year period.
Results |
There were 11 incident melanomas diagnosed during a total follow-up of 1280 patient-years. The mean interval between the first transplant and diagnosis was 5.5 years. Only 2 melanomas were >1 mm in Breslow thickness. Seven melanomas (64%) arose de novo. A contiguous nevus was present in 4 cases. Metastatic disease did not develop in the melanoma patients during the follow-up period, and all remain alive. The needed to excise for every melanoma diagnosed ratio was 16:1.
Limitations |
The crude incidence rates were age standardized, unlike the comparison rates of melanoma in the general population, and the cohort was small.
Conclusion |
Most melanomas diagnosed in OTR patients attending a specialized transplant dermatology service were detected early. Our data suggest early detection may reduce the proportion of OTRs presenting with thick melanomas, thus improving prognosis and patient outcomes. A needed to excise for every melanoma diagnosed ratio of 16:1 is not unreasonable for this cohort of high-risk patients. To our knowledge, this is the first time this ratio has been calculated for a cohort of OTRs.
Le texte complet de cet article est disponible en PDF.Key words : biopsied pigmented lesions, histopathology, immunosuppression, keratinocyte cancers, melanoma, multimodal therapy, organ transplant recipients, pigmented cutaneous lesions, post-transplantation, solid organ transplantation, transplant dermatology
Abbreviations used : mTOR, OTR, SCF
Plan
Funding sources: None. |
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Conflicts of interest: None disclosed. |
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IRB approval status: Human Research Ethics clearance was not required. |
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