Immune status does not independently influence cutaneous squamous cell carcinoma metastasis and death when stratified by tumor stage: A dual-center retrospective cohort analysis of primary N0 disease - 30/11/22
Abstract |
Background |
Although immunocompromised patients have a higher risk of developing cutaneous squamous cell carcinomas, it is unknown whether immune status is an independent risk factor for poor outcomes.
Objective |
To compare cutaneous squamous cell carcinoma outcomes in immunocompromised and immunocompetent patients when controlling for T-stage.
Methods |
We performed a retrospective cohort study at 2 tertiary care centers, examining 989 primary tumors from 814 immunocompromised patients (solid organ transplant: 259 [31.7%], chronic lymphocytic leukemia: 113 [13.9%]) and 6608 tumors from 4198 immunocompetent patients. Our primary outcome was the composite of disease-specific death or tumor metastasis (“poor outcomes”).
Results |
Immunocompromised patients had 50% more high T-stage tumors (ie, Brigham and Women’s Hospital stage T2b and T3), than immunocompetent patients (3.3% vs 4.9%, respectively; P < .001). Significant predictors of poor outcomes included tumor stage (sub hazards ratio [SHR], 14.8 for high T-stage tumors; 95% confidence interval [CI], 8.0-27.6; P < .001) and male sex (SHR, 2.3; 95% CI, 1.4-3.8; P = .002). Immune status was not a significant predictor (SHR, 1.04; 95% CI, 0.69-1.6; P = .85).
Limitations |
This study is retrospective.
Conclusion |
Although immunocompromised patients had 50% more high T-stage tumors than immunocompetent patients, immunocompromised patients had a similar chance of metastasis and disease-specific death when adjusting for T-stage in our cohort of primary tumors.
El texto completo de este artículo está disponible en PDF.Key words : cutaneous squamous cell carcinoma, immunosuppression, immunocompromised, outcomes research, solid organ transplant, tumor staging
Abbreviations used : AJCC8, BWH, CLL, cSCC, DSD, LR, MMS, OR, PNI, SHR
Esquema
| Drs Koyfman and Ruiz are cosenior authors. |
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| Funding sources: Supported in part by the Melvin Markey Discovery Fund at Cleveland Clinic. |
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| IRB approval status: Approved and reviewed by the Mass General Brigham Human Research Committee and the Cleveland Clinic Institutional Review Board. |
Vol 87 - N° 6
P. 1295-1302 - décembre 2022 Regresar al número
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