Background Renal transplantation is associated with an increased
incidence of nonmela-noma skin cancer (NMSC) caused by
immunosuppression. Squamous cell carcinoma (SCC) and basal cell
carcinoma (BCC), the two major histological types of NMSC, exhibit more
aggressive biological and clinical courses in renal transplant
recipients (RTRs), with higher rates of recurrence and mortality than in
the general population.
Methods We retrospectively analyzed our experience of NMSC in 1736 renal
transplantations performed over a 25- year period. All cases of skin
cancer after renal transplantation were included except those of skin
cancer resulting from melanoma and mesenchymal skin tumors.
Results In our series, the overall incidence of NMSC after
transplantation was 2.2% (n = 39), and SCC represented the most
frequent skin malignancy (64.1%), followed by BCC (17.9%), Bowen’s
disease (10.2%), basosquamous carcinoma (5.1%), and a rare case of
invasive sebaceous carcinoma (2.6%). A shift to newer immunosuppressive
regimens after the initial diagnosis of NMSC had been implemented in
eight cases (20.5%). The recurrence rate after initial treatment was
41% (n = 16), and distant metastatic disease was diagnosed in 15.4% (n
= 6) of NMSC patients. The NMSC- specific mortality rate was 25.6% (n =
10).
Conclusions Nonmelanoma skin cancer remains a significant source of
morbidity and mortality in RTRs, and post- transplant surveillance
should be increased
