SKIN MALIGNANCY IN TRANSPLANT RECIPIENTS:

P850 Skin cancer is the most common malignancy identified among transplant recipients. Considerable differences exist in tumor distribution and biologic activity between transplant recipients and patients in the general population. This study seeks to highlight some of those significant differences Methods: A retrospective review of all transplant recipients with skin malignancies was performed. Patient demographics and tumor characteristics were examined. Results: 2018 transplant recipients from the United States with skin malignancies were examined. Three main groups were identified: squamous cell cancer (SCC), basal cell cancer (BCC), and concomitant malignancies (BCC/SCC). Squamous cell to basal cell cancer ratio was found to be 1.9 to 1. Mean patient age was similar among all groups. The ratio of extra-renal to renal allograft recipients was identical for all three groups (3:1). The interval from transplant to malignancy was long (>50mos) compared to other solid organ or lymphotogenous malignancies, with the greatest interval identified among those with isolated SCC lesions. In the SCC group, there was a 9% incidence of nodal or secondary site involvement affecting the cervix, perineum, or lung. The highest recurrence rate was demonstrated in the combined malignancy group. The interval to recurrence was greatest in the mixed tumor group (41.0 ± 38.6 months), followed by the BCC (29.3 ± 27.5 mos) and SCC (27.3 ± 28.5 mos) groups.FigureCancer specific deaths were significantly higher in the SCC (8%) and BBC/SCC (6.8%) group compared to BCC (3.6%). Conclusions: In the patients reported to the Registry, skin cancer was the most common malignancy. SCC was observed with greater frequency in reported transplant recipients compared to that seen in the general population. Skin malignancies occur after long interval of immunosuppression. SCC alone or in combination with BCC appears aggressive, and often carries with it significant mortality. However, the highest incidence of recurrence was demonstrated in the mixed tumor group.