Organ transplant recipients with Merkel cell carcinoma have reduced progression-free, overall, and disease-specific survival independent of stage at presentation - 17/09/14
Abstract |
Background |
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma of the skin. Immunosuppression is associated with increased incidence of MCC.
Objective |
We sought to determine whether solid organ transplant recipients (SOTR) with MCC had decreased progression-free, disease-specific, and overall survival compared with immunocompetent patients.
Methods |
We conducted a retrospective cohort study examining 8 SOTR with MCC and 89 immunocompetent control subjects. Cox regression models were generated for outcomes of progression, disease-specific death, and death from any cause, adjusted for patient sex, age at diagnosis, and stage at presentation.
Results |
SOTR had a 4.1-fold increased hazard for progression (95% confidence interval 1.57-10.95, P = .004), a 10.5-fold increased hazard for all-cause mortality (95% confidence interval 3.06-35.98, P < .0001), and an 11.9-fold increased hazard for MCC-specific death (95% confidence interval 2.67-53.08, P = .001), adjusted for sex, age, and stage at presentation. SOTR had decreased 1-year overall survival, 46.8% versus 88.6%, and decreased 1-year MCC-specific survival, 56.3% versus 95.2%.
Limitations |
This is a single-center study from a tertiary academic care center, and may not be generalizable to all patient populations.
Conclusions |
SOTR have a significant reduction in overall, MCC-specific, and progression-free survival compared with immunocompetent patients. Further studies will determine whether aggressive treatment may improve outcomes in this high-risk population.
Le texte complet de cet article est disponible en PDF.Key words : Merkel cell carcinoma, organ transplant, outcomes, survival
Abbreviations used : CI, CLL, HR, MCC, SOTR
Plan
| Dr Arron is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through University of California, San Francisco–Clinical and Translational Science Institute grant number KL2 TR000143. |
|
| Conflicts of interest: None declared. |
Vol 71 - N° 4
P. 684-690 - octobre 2014 Retour au numéro
Article précédent
- Mortality of patients with bullous pemphigoid in Korea
- Ji Hye Lee, Soo-Chan Kim
- An objective measure of growth rate using partial biopsy specimens of melanomas that were initially misdiagnosed
- Matthew J. Lin, Victoria Mar, Catriona McLean, John W. Kelly
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?