Sebaceous Carcinoma Incidence and Survival Among Solid Organ
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Risk of sebaceous carcinoma (SC), a rare skin cancer associated with Muir-Torre syndrome, is elevated among solid organ transplant recipients (SOTRs). To assess SC incidence and patient survival after solid organ transplantation a study was conducted.

This cohort study, conducted from January 1, 1987, to December 31, 2017 , used data from the Transplant Cancer Match Study. Data on demographic and transplant characteristics as well as induction and initial maintenance immunosuppressive therapies were obtained from the transplant registry. Standardized incidence ratios (SIRs) comparing SC incidence among SOTRs to the general population were calculated. Incidence rate ratios (IRRs) comparing SC risk between SOTR subgroups were calculated using multivariate Poisson regression. Cox regression was used to compare overall survival between SC cases in SOTRs and other individuals.

Sebaceous carcinoma incidence and overall patient survival after transplantation compared with the general population was recorded.

A total of 326 282 transplant procedures were performed for 301 075 patients. A total of 102 SCs were diagnosed in 301075 SOTRs, corresponding to a 25-fold increased incidence. Incidence was especially elevated among lung recipients and after a posttransplant diagnosis of cutaneous squamous cell carcinoma. Among SOTRs, factors independently associated with SC risk included male sex, race/ethnicity (non-Hispanic Black vs non-Hispanic White) older age, use of thymoglobulin induction, posttransplant cutaneous squamous cell carcinoma, and longer time since transplant.

Muir-Torre syndrome–associated cancers were rare among both SOTRs and others with SC (3.3%-4.1%). Among patients with SC, prior transplantation was associated with increased overall mortality, although few deaths were attributed to SC SOTRs [4.3%]; 235 of 3585 non-SOTRs [6.6%].

Among SOTRs, results of this large cohort study suggest that SC was associated with measures of immunosuppression, and overall survival was worse than for other patients with SC. Findings also suggest a possible role for UV radiation in carcinogenesis.