Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada.,Journal of the American Academy of Dermatology

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Melanoma incidence, stage, and survival after solid organ transplant: A population-based cohort study in Ontario, Canada.
Journal of the American Academy of Dermatology ( IF 12.8 ) Pub Date : 2020-02-25 , DOI: 10.1016/j.jaad.2019.09.072
Christina K Park ₁ , Erin J Dahlke ₂ , Kinwah Fung ₃ , Jessica Kitchen ₄ , Peter C Austin ₃ , Paula A Rochon ₅ , An-Wen Chan ₆

Affiliation

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.

中文翻译：

实体器官移植后黑色素瘤的发生，阶段和生存：加拿大安大略省一项基于人群的队列研究。

背景

实体器官移植后，黑色素瘤的风险增加，且后果可能更糟。

目的

评估黑色素瘤移植受者的发生率，分期和生存率。

方法

使用链接的行政数据库进行基于人口的回顾性观察研究。从1991年至2012年接受首次实体器官移植的成年人被随访至2013年12月。

结果

我们从非移植人群中鉴定出51名患有黑色素瘤的移植受者，11 369名没有黑色素瘤的受者以及255名匹配的黑色素瘤患者。移植受体的黑素瘤风险增加（标准发生率，2.29； 95％置信区间[CI]，2.07-2.49），并且更有可能在II至IV期被诊断出来（校正比值比，4.29； 95％CI，2.04） -9.00）与非移植人群相比。与非移植人群相比，移植受者的黑素瘤特异性死亡率增加了（调整后的危险比为1.93； 95％CI为1.03-3.63）。在移植接受者中，黑色素瘤发生后的全因死亡率比无黑色素瘤者高（T1 / T2期：调整后的危险比，2.18； 95％CI，1.13-4.21； T3 / T4：调整后的危险比，4.07； 95％CI ，2.36-7.04； III / IV：调整后的风险比为7.92；95％CI，3.76-16.70）。