Risk of Non-melanoma Skin Cancer in Kidney Transplantation Recipient: An Evidence-based Case Report
Keywords:
non-melanoma skin cancer, renal transplant recipient, renal transplantationAbstract
Background: Renal transplantation is the most common organ transplantation procedure in Indonesia. Renal transplant recipients (RTRs) were found to carry 3-to-5-time higher risk of cancer compared to the normal population. Around 40% of cancers in RTR patients were non-melanoma skin cancer (NMSC). It was found to be correlated with several risk factors. The study aimed to determine the prognostic factors for NMSC in RTRs with Indonesian skin colors. Methods: The article search was conducted on three different journal databases, which were Cochrane, PubMed, and Embase. Relevant articles were appraised using critical appraisal guidelines from The Centre for Evidence-Based Medicine (CEBM), University of Oxford. Results: Four articles were selected for appraisal. Incidence of NMSC on RTRs in these studies were 25,2% (CI 24,67%-32,47%), 6,67% (CI 2,87%-10,47%), 23,67% (CI 19,38%-27,96%) and 28,57% (CI 24,67%-32,47%). Prognostic factors correlated with the incidence of NMSC on RTRs were age, sun exposure, history of sunburn, existing chronic actinic lesion, lentigo solaris, precancerous lesion including actinic keratoses, and consumption of cyclosporine and tacrolimus during maintenance therapy. Conclusion: Combination of age, environmental factors, sun exposure-related skin lesion, and immunosuppressant therapy are the main prognostic factors of NMSC on RTRs.References
World Health Organization. Transplantation [Internet]. [cited 28 March 2021]. Available from: https://www.who.int/transplantation/gkt/statistics/en/
Divisi-Nefrologi. Data Transplantasi Ginjal RSCM. Jakarta; 2021.
Wong G, Chapman JR. Cancers after renal transplantation. Transplant Rev. 2008;22(2):141–9.
Kearney L, Hogan D, Conlon P, et al. High-risk cutaneous malignancies and immunosuppression: Challenges for the reconstructive surgeon in the renal transplant population. J Plast Reconstr Aesthetic Surg [Internet]. 2017;70(7):922–30. Available from: http://dx.doi.org/10.1016/j.bjps.2017.03.005
Chu M, Beal B, Maher I. Cutaneous Malignancies. In: Nunley J, Lerma E, editor. Dermatological manifestation of kidney disease. 1st ed. Springer; 2015. p. 191–210.
Oh CC, Lee HY, Tan BK, et al. Dermatological conditions seen in renal transplant recipients in a Singapore tertiary hospital. Singapore Med J. 2018;59(10):519–23.
Heo J, Noh OK, Oh Y-T, et al. Cancer risk after renal transplantation in South Korea: a nationwide population-based study. BMC Nephrol. 2018;19(1):1–6.
Baghel N, Awasthi S, Kumar SS. Cutaneous manifestations in renal transplant recipients. Int J Res Med Sci. 2017;5(5):1823.
Bernat-García J, Morales Suárez-Varela M, Vilata-Corell JJ, et al. The role of new immunosuppressive drugs in nonmelanoma skin cancer in renal transplant recipients. Actas Dermo-Sifiliográficas (English Ed). 2014;105(10):940–6.
Gonçalves CP, Trope BM, Ramos-e-Silva M. Non-melanoma skin cancer in renal transplant recipients: A study in a Brazilian reference center. Clin Cosmet Investig Dermatol. 2015;8:339–44.
Kaufmann RA, Oberholzer PA, Cazzaniga S, et al. Epithelial Skin cancers after kidney transplantation: a retrospective single-centre study on 376 recipients. Eur J Dermatol. 2016;26(3):256–70.
Zavattaro E, Fava P, Veronese F, et al. Identification of risk factors for multiple non-melanoma skin cancers in italian kidney transplant recipients. Med. 2019;55(6):1–12.
Greenberg JN, Zwald FO. Management of skin cancer in solid-organ transplant recipients: A multidisciplinary approach. Dermatol Clin [Internet]. 2011;29(2):231–41. Available from: http://dx.doi.org/10.1016/j.det.2011.02.004
Pritchett EN, Doyle A, Shaver CM, Miller B, Abdelmalek M, Cusack CA, Malat GE, Chung CL. Nonmelanoma skin cancer in nonwhite organ transplant recipients. JAMA dermatology. 2016;152(12):1348-53.
Kovitwanichkanont T, Chong AH. Skin cancer prevention, chemoprevention, and revision of immunosuppression. In: Nathalie C. Zeitouni, Samie FH, editor. Dermatology and solid organ transplantation. 1 ed. New York: Taylor & Francis; 2021. p. 23–33.
Mackintosh LJ, Geddes CC, Herd RM. Skin tumours in the West of Scotland renal transplant population. Br J Dermatol. 2013;168(5):1047–53.
Kim IY, He YY. Ultraviolet radiation-induced non-melanoma skin cancer: Regulation of DNA damage repair and inflammation. Genes Dis [Internet]. 2014;1(2):188–98. Available from: http://dx.doi.org/10.1016/j.gendis.2014.08.005
Walsh SB, Xu J, Xu H, et al. Cyclosporine A mediates pathogenesis of aggressive cutaneous squamous cell carcinoma by augmenting epithelial-mesenchymal transition: role of TGF-β signaling pathway. Mol Carcinog. 2011;50(7):516–27.
Marin EP, Cohen E, Malhotra D. Immunosuppressive therapy for solid organ transplantation. In: Nathalie C. Zeitouni, Samie FH, editor. Dermatology and solid organ transplantation. 1 ed. New York: Taylor & Francis; 2021. p. 23–33.
Knoll GA, Kokolo MB, Mallick R, et al. Effect of sirolimus on malignancy and survival after kidney transplantation: Systematic review and meta-analysis of individual patient data. BMJ [Internet]. 2014;349(November):1–14. Available from: http://dx.doi.org/doi:10.1136/bmj.g6679
Park GH, Chang SE, Won CH, et al. Incidence of primary skin cancer after organ transplantation: An 18-year single-center experience in Korea. J Am Acad Dermatol [Internet]. 2014;70(3):465–72. Available from: http://dx.doi.org/10.1016/j.jaad.2013.10.024
Downloads
Published
How to Cite
Issue
Section
License
CopyrightThe authors who publish this journal agree to the following requirements:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.