Cutaneous malignant melanoma in the Swedish organ transplantation cohort: A study of clinicopathological characteristics and mortality - 17/06/15
Abstract |
Background |
Risk of cutaneous melanoma is increased among organ transplant recipients (OTRs) but outcome has rarely been evaluated.
Objective |
We sought to assess melanoma characteristics and prognosis among OTRs versus the general population.
Methods |
Using Swedish health care registers, we identified melanomas in OTRs (n = 49) and in the general population (n = 22,496), given a diagnosis between 1984 and 2008 and followed up through December 31, 2012. Tumor slides of posttransplantation melanomas were reviewed. Odds ratios for comparison of histopathological characteristics and hazard ratios of melanoma-specific death were calculated.
Results |
Among OTRs the trunk was the most common anatomic melanoma site (50% among female vs 51% among male) and 73% (n = 36) of all melanomas were histologically associated with a melanocytic nevus, 63% (n = 31) atypical/dysplastic. Compared with population melanomas, posttransplantation melanomas were more advanced at diagnosis (Clark level III-V: odds ratio 2.2 [95% confidence interval 1.01-4.7, P = .03], clinical stages III-IV: odds ratio 4.2 [1.6-10.8, P = .003]). Risk of melanoma-specific death was increased among OTRs: adjusted hazard ratio 3.0 (1.7-5.3, P = .0002).
Limitations |
Only posttransplantation melanoma slides were reviewed.
Conclusions |
Melanomas were more advanced at diagnosis and melanoma-specific survival was poorer in OTRs than in the general population. Prophylactic excision of truncal nevi among OTRs may be advised.
Le texte complet de cet article est disponible en PDF.Key words : histopathology, immunosuppression, melanocytic nevi, melanoma, melanoma-specific mortality, population-based study, posttransplantation, Swedish Melanoma Register
Abbreviations used : AJCC, CI, HR, OTR, SSM, TIL
Plan
Funded by Welander Foundation, Westerberg Foundation, and Strategic Research Program in Epidemiology at Karolinska Institutet, Stockholm, Sweden. |
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Conflicts of interest: None declared. |
Vol 73 - N° 1
P. 106 - juillet 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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