Defining the clinical course of metastatic skin cancer in organ transplant recipients: a multicenter collaborative study

Arch Dermatol. 2003 Mar;139(3):301-6. doi: 10.1001/archderm.139.3.301.


Objective: To evaluate the demographic characteristics, clinical course, and outcome in organ transplant recipients with metastatic skin cancer.

Design and setting: An international, multicenter, Internet-coordinated collaborative group retrospectively analyzed data from 68 organ transplant recipients with 73 distinct metastatic skin cancers.

Main outcome measurements: The Kaplan-Meier method was used to estimate the cumulative incidence of relapse, overall survival, and disease-specific survival after metastatic skin cancer. Univariate Cox proportional hazards models were fit to evaluate factors for an association with survival.

Results: Metastasis from skin cancer in organ transplant recipients most commonly consisted of squamous cell carcinoma in regional nodal basins. It was predominantly treated with a combination of surgery and irradiation. By 1 year after metastasis, the cumulative incidence of relapse was 29%, and the 3-year disease-specific survival was 56%. Patients whose initial metastases were distant or systemic had a significantly poorer disease-specific survival than those whose initial metastases were in-transit or regional (risk ratio, 6.5; P<.001).

Conclusions: Metastatic skin cancer in organ transplant recipients has a poor prognosis. Preventive, early, and aggressive therapeutic interventions are required to minimize this serious complication of transplant-associated immunosuppression.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Merkel Cell / epidemiology
  • Carcinoma, Merkel Cell / etiology
  • Carcinoma, Merkel Cell / mortality
  • Carcinoma, Merkel Cell / secondary
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / etiology
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / secondary
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Lymphatic Metastasis
  • Male
  • Medical Records
  • Melanoma / epidemiology
  • Melanoma / etiology
  • Melanoma / mortality
  • Melanoma / secondary
  • Organ Transplantation*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / etiology
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • Survival Analysis
  • United States / epidemiology