WEDNESDAY, June 14, 2023 -- Squamous cell carcinomas (SCCs) in organ transplant recipients (OTRs) have worse prognostic features than SCCs in the general population, according to a study published online June 14 in JAMA Dermatology.

Nirmala Pandeya, Ph.D., from the QIMR Berghofer Medical Research Institute in Brisbane, Australia, and colleagues examined the extent to which major high-risk features of SCC in OTRs differ from SCCs in the general population in a dual-cohort study, which included one cohort of OTRs at high risk for skin cancer (Skin Tumours in Allograft Recipients study) and a population-based cohort (QSkin Sun and Health Study). A total of 741 SCCs excised from 191 OTRs and 2,558 SCCs from 1,507 persons in the general population were included.

The researchers found that in OTRs, the SCCs developed most frequently on the head/neck (38.6 percent), while in the general population, they developed most frequently on arms/hands (35.2 percent). Perineural invasion was more than twice as common in OTRs as in population cases after adjusting for age and sex (prevalence ratio, 2.37), as was invasion to/beyond subcutaneous fat (prevalence ratio, 2.37). OTRs had more than a threefold increased prevalence of poorly versus well-differentiated SCCs (prevalence ratio, 3.45), while the prevalence of tumors >20 mm versus ≤20 mm was moderately higher in OTRs (prevalence ratio, 1.52).

"This finding, along with the greater multiplicity of SCCs in OTRs, warrants intensive surveillance of affected OTRs optimally with multidisciplinary specialist care, at the same time recognizing that all SCCs with high-risk features warrant intensive therapy and follow-up," the authors write.

Several authors disclosed ties to industry; one author holds a patent.