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Cutaneous malignant melanoma in the Swedish organ transplantation cohort: A study of clinicopathological characteristics and mortality
Karolinska University of Labs, Sweden; Karolinska University, Sweden.
Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden.
Karolinska University Hospital, Sweden.
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2015 (English)In: The Journal of American Academy of Dermatology, ISSN 0190-9622, E-ISSN 1097-6787, Vol. 73, no 1, 106-U190 p.Article in journal (Refereed) Published
Abstract [en]

Background: Risk of cutaneous melanoma is increased among organ transplant recipients (OTRs) but outcome has rarely been evaluated. Objective: We sought to assess melanoma characteristics and prognosis among OTRs versus the general population. Methods: Using Swedish health care registers, we identified melanomas in OTRs (n = 49) and in the general population (n = 22,496), given a diagnosis between 1984 and 2008 and followed up through December 31, 2012. Tumor slides of posttransplantation melanomas were reviewed. Odds ratios for comparison of histopathological characteristics and hazard ratios of melanoma-specific death were calculated. Results: Among OTRs the trunk was the most common anatomic melanoma site (50% among female vs 51% among male) and 73% (n = 36) of all melanomas were histologically associated with a melanocytic nevus, 63% (n = 31) atypical/dysplastic. Compared with population melanomas, posttransplantation melanomas were more advanced at diagnosis (Clark level III-V: odds ratio 2.2 [95% confidence interval 1.01-4.7, P = .03], clinical stages III-IV: odds ratio 4.2 [1.6-10.8, P = .003]). Risk of melanoma-specific death was increased among OTRs: adjusted hazard ratio 3.0 (1.7-5.3, P = .0002). Limitations: Only posttransplantation melanoma slides were reviewed. Conclusions: Melanomas were more advanced at diagnosis and melanoma-specific survival was poorer in OTRs than in the general population. Prophylactic excision of truncal nevi among OTRs may be advised.

Place, publisher, year, edition, pages
Elsevier , 2015. Vol. 73, no 1, 106-U190 p.
Keyword [en]
histopathology; immunosuppression; melanocytic nevi; melanoma; melanoma-specific mortality; population-based study; posttransplantation; Swedish Melanoma Register
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-120038DOI: 10.1016/j.jaad.2015.03.045ISI: 000356314100031PubMedID: 25929720OAI: oai:DiVA.org:liu-120038DiVA: diva2:840021
Note

Funding Agencies|Welander Foundation; Westerberg Foundation; Strategic Research Program in Epidemiology at Karolinska Institutet, Stockholm, Sweden

Available from: 2015-07-06 Created: 2015-07-06 Last updated: 2016-04-24

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Lyth, Johan
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Department of Clinical Pathology and Clinical GeneticsDepartment of Clinical and Experimental MedicineFaculty of Medicine and Health SciencesDivision of Clinical SciencesRegional Cancer Center South East Sweden
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The Journal of American Academy of Dermatology
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