Skin Cancer in Organ Transplant Recipients—Where Do We Stand Today?
Article first published online: 8 SEP 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 11, pages 2192–2198, November 2008
How to Cite
Ulrich, C., Kanitakis, J., Stockfleth, E. and Euvrard, S. (2008), Skin Cancer in Organ Transplant Recipients—Where Do We Stand Today?. American Journal of Transplantation, 8: 2192–2198. doi: 10.1111/j.1600-6143.2008.02386.x
- Issue published online: 9 OCT 2008
- Article first published online: 8 SEP 2008
- Received 08 April 2008, revised 03 July 2008 and accepted for publication 16 July 2008
- mTOR inhibitors;
- organ transplantation;
- skin cancer prophylaxis;
- skin cancer treatment;
Skin cancers are the most frequent malignancies in organ transplant recipients (OTR), with 95% being nonmelanoma skin cancers (NMSC), especially squamous (SCC) and basal cell carcinomas. Most OTR with a first SCC subsequently develop multiple NMSC within 5 years, highlighting the concept of ‘field cancerization’, and are also at high risk for noncutaneous cancers. In order to reduce the tumor burden in these patients, their management requires an interdisciplinary approach including revision of immunosuppression, new dermatological treatments and adequate education about photoprotection in specialized dermatology clinics for OTR. Whereas surgery remains the gold-standard therapy for NMSC, noninvasive methods have shown promising results to treat superficial keratoses and subclinical lesions on large body areas. Although the threshold of skin cancer necessitating revision of immunosuppression is debated, this measure should be envisaged at the occurrence of the first SCC, or in case of multiple non-SCC NMSC. While the role of immunosuppressants in the occurrence of NMSC is widely recognized, the best immunosuppressive strategies remain to be defined. Presently, randomized prospective studies assess the burden of new skin tumors, as well as graft and patient survival, in patients with one or several NMSC after the introduction of mTOR (mammalian target of rapamycin) inhibitors.