Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada - 19/08/20
Abstract |
Background |
Risk of melanoma is increased with potentially worse outcomes after solid organ transplant.
Objective |
To estimate the incidence, stage, and survival in transplant recipients with melanoma.
Methods |
Population-based, retrospective, observational study using linked administrative databases. Adults receiving their first solid organ transplant from 1991 through 2012 were followed to December 2013.
Results |
We identified 51 transplant recipients with melanoma, 11 369 recipients without melanoma, and 255 matched patients with melanoma from the nontransplant population. Transplant recipients were at increased risk of melanoma (standardized incidence ratio, 2.29; 95% confidence interval [CI], 2.07-2.49) and more likely to be diagnosed at stages II through IV (adjusted odds ratio, 4.29; 95% CI, 2.04-9.00) compared with the nontransplant population. Melanoma-specific mortality was increased in transplant recipients compared with the nontransplant population (adjusted hazard ratio, 1.93; 95% CI, 1.03-3.63). Among transplant recipients, all-cause mortality was increased after melanoma compared with those without melanoma (stage T1/T2: adjusted hazard ratio, 2.18; 95% CI, 1.13-4.21; T3/T4: adjusted hazard ratio, 4.07; 95% CI, 2.36-7.04; III/IV: adjusted hazard ratio, 7.92; 95% CI, 3.76-16.70).
Limitations |
The databases did not contain data on immunosuppressive drugs; ascertainment of melanoma metastasis relied on pathology reports.
Conclusion |
Melanoma after solid organ transplant is more often diagnosed at a later stage and leads to increased mortality, even for early-stage tumors.
Le texte complet de cet article est disponible en PDF.Key words : epidemiology, immunosuppression, melanoma, population-based cohort, statistics, transplant
Abbreviation used : CI
Plan
| Funding sources: Supported by the Canadian Dermatology Foundation. The work was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care. Parts of this material are based on data and information provided by Cancer Care Ontario (CCO). The opinions, results, views, and conclusions reported in this article are those of the authors and do not necessarily reflect those of CCO. No endorsement by CCO is intended or should be inferred. |
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| Disclosure: Dr Austin is supported in part by a Mid-Career Investigator Award from the Heart & Stroke Foundation. Dr Rochon holds the Retired Teachers of Ontario/Les enseignantes et enseignants retraites de l'Ontario Chair in Geriatric Medicine from the University of Toronto. Drs Park and Dahlke, Ms Fung, Ms Kitchen, and Dr Chan have no conflicts of interest to declare. |
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| IRB approval status: Approved by Women's College Hospital. |
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| Reprints not available from the authors. |
Vol 83 - N° 3
P. 754-761 - septembre 2020 Retour au numéro
Article précédent
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