Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region-Comparison between solid organ transplant recipients and immunocompetent patients

Amit Ritter; Samih Badir; Muhammad Mansour; Zvi Segal; Dean Ad-El; Gideon Bachar; Thomas Shpitzer; Aron Popovtzer; Aviram Mizrachi

doi:10.1002/hed.26546

Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region-Comparison between solid organ transplant recipients and immunocompetent patients

Head Neck. 2021 Mar;43(3):884-894. doi: 10.1002/hed.26546. Epub 2020 Nov 27.

Authors

Amit Ritter^{1

2}, Samih Badir^{1

2}, Muhammad Mansour^{2

3}, Zvi Segal^{2

3}, Dean Ad-El^{2

3}, Gideon Bachar^{1

2}, Thomas Shpitzer^{1

2}, Aron Popovtzer^{2

4}, Aviram Mizrachi^{1

2}

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
² Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
³ Department of Plastic Surgery and Burns, Rabin Medical Center, Petah Tikva, Israel.
⁴ Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.

PMID: 33247523
DOI: 10.1002/hed.26546

Abstract

Background: Cutaneous squamous cell carcinoma of the head and neck (CSCC-HN) appears to behave more aggressively in immunosuppressed patients. We aimed to investigate this hypothesis by comparing solid organ transplant recipients (SOTR) with CSCC-HN to immunocompetent patients.

Methods: A retrospective comparative study was conducted for SOTR and immunocompetent patients who were treated for CSCC-HN.

Results: A total of 177 SOTR and 157 immunocompetent patients with CSCC-HN were included. Lymph node metastases were more common in the SOTR group (9% vs 3%), and distant metastases occurred only in SOTR (3% of patients). SOTR had a higher rate of recurrences (19% vs 10%), which were mostly regional (7%) and distant (3%). The 2-year disease-specific survival of SOTR was lower (93% vs 100%).

Conclusions: SOTR with CSCC-HN has significantly worse outcomes compared to immunocompetent patients. Solid-organ transplantation should be regarded as a negative prognostic factor in patients with CSCC-HN.

Keywords: head and neck cancer; skin cancer; solid organ; squamous cell carcinoma; transplantation.

MeSH terms

Carcinoma, Squamous Cell* / therapy
Humans
Neoplasm Recurrence, Local
Organ Transplantation* / adverse effects
Prognosis
Retrospective Studies
Skin Neoplasms*
Squamous Cell Carcinoma of Head and Neck