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Identification of Risk Factors for Multiple Non-Melanoma Skin Cancers in Italian Kidney Transplant Recipients

1
Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli, 17-28100 Novara, Italy
2
Department of Medical Sciences, University of Turin, 10126 Turin, Italy
3
Department of Health Science, University of Eastern Piedmont, 28100 Novara, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2019, 55(6), 279; https://doi.org/10.3390/medicina55060279
Received: 20 January 2019 / Revised: 7 April 2019 / Accepted: 7 June 2019 / Published: 16 June 2019
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Abstract

Background and objectives: Non-melanoma skin cancers (NMSCs) represent the most frequently encountered malignancy in organ transplant recipients and their incidence increases proportionally to the duration of immunosuppression. Furthermore, patients of this group often develop multiple and more aggressive cancers and, to date, risk factors for the development of multiple NMSCs have not been yet established. The present study aimed to identify risk factors for multiple NMSCs in a cohort of Italian kidney transplant recipients (KTRs). Materials and Methods: We consecutively included all KTRs referring to two post-transplant outpatient clinics of North-Western Italy between 2001 and 2017. In this cohort, we evaluated different clinical (endogenous and exogenous) risk factors in order to establish their correlation with NMSCs. Results: 518 KTRs were included, of which 148 (28.6%) developed keratinocyte cancers, with a single tumor in 77 subjects, two skin cancers in 31 patients, 3 in 21 patients, whereas at least 4 NMSCs developed in 19 KTRs. We observed an increased risk of the development of cutaneous neoplasms for the male gender, old age at transplantation (>50 years), light phototype, solar lentigo, history of sunburns, or chronic actinic damage. Considering patients affected by multiple keratinocyte neoplasms, we observed a significant association of actinic damage and solar lentigo with an increased risk of NMSCs; their significance was confirmed even at the multivariable model. Conclusions: Our results confirm the role played by chronic cutaneous actinic damage in carcinogenesis on KTRs and highlight the significance of individualized periodic dermatological screening. View Full-Text
Keywords: carcinogenesis; immunosuppression; non-melanoma skin cancer; risk factors; skin cancer; transplanted patients carcinogenesis; immunosuppression; non-melanoma skin cancer; risk factors; skin cancer; transplanted patients
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Zavattaro, E.; Fava, P.; Veronese, F.; Cavaliere, G.; Ferrante, D.; Cantaluppi, V.; Ranghino, A.; Biancone, L.; Fierro, M.T.; Savoia, P. Identification of Risk Factors for Multiple Non-Melanoma Skin Cancers in Italian Kidney Transplant Recipients. Medicina 2019, 55, 279.

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