Wackel Megan, Thomas Sierra, Schmidt Cynthia M, Zheng Cheng, Wysong Ashley, Whitley Melodi J
Department of Dermatology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Spencer Fox Eccles School of Medicine, University of Utah Health, Salt Lake City, Utah, USA.
JID Innov. 2024 Jun 5;4(5):100294. doi: 10.1016/j.xjidi.2024.100294. eCollection 2024 Sep.
Patients who are immunosuppressed, such as solid organ transplant recipients (SOTRs), are at a higher risk of developing cutaneous squamous cell carcinoma (cSCC). This population is at a higher risk of metastasis and worse disease-specific survival. The objective of this review is to better characterize the immunosuppressed population with metastatic cSCC. A literature search was conducted to identify reports of lymphatic metastases in immunosuppressed patients with cSCC. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed during creation of a cohort with desired inclusion and exclusion criteria. One hundred and thirty-five articles met the inclusion/exclusion criteria, yielding 1020 total cases. We discovered that the most common forms of immunosuppression within the cohort were solid organ transplantation and hematologic malignancy. White males and cSCC tumors involving the head and neck comprised most cases. Using Brigham and Women's Hospital and Eighth edition of American Joint Committee on Cancer tumor staging criteria, we observed a trend toward higher stage tumors in SOTR than in patients with hematologic malignancy. This review confirms that known clinical risk factors for metastatic cSCC appear to be similar among the immunosuppressed population and the cSCC population at large. Interestingly, our data suggest that current staging systems may not accurately reflect metastatic risk among patients with hematologic malignancy.
免疫功能低下的患者，如实性器官移植受者（SOTR），发生皮肤鳞状细胞癌（cSCC）的风险更高。这一人群发生转移的风险更高，疾病特异性生存率更低。本综述的目的是更好地描述发生转移性cSCC的免疫功能低下人群的特征。进行文献检索以确定免疫功能低下的cSCC患者发生淋巴转移的报告。在创建具有所需纳入和排除标准的队列时遵循了系统评价和Meta分析的首选报告项目指南。135篇文章符合纳入/排除标准，共产生1020例病例。我们发现队列中最常见的免疫抑制形式是实体器官移植和血液系统恶性肿瘤。大多数病例为白人男性以及累及头颈部的cSCC肿瘤。使用布莱根妇女医院和美国癌症联合委员会第八版肿瘤分期标准，我们观察到SOTR患者的肿瘤分期有高于血液系统恶性肿瘤患者的趋势。本综述证实，转移性cSCC已知的临床风险因素在免疫功能低下人群和总体cSCC人群中似乎相似。有趣的是，我们的数据表明，目前的分期系统可能无法准确反映血液系统恶性肿瘤患者的转移风险。
