Clinical Equipoise and Unimproved Outcomes following Posttransplant Cutaneous Squamous Cell Carcinoma

IntroductionCutaneous squamous cell carcinoma (CSCC) is the most common malignancy following solid organ transplantation.Historical data suggest that 25% of kidney transplant recipients develop additional CSCC within a year of their first lesion, with significantly increased risks of metastasis and mortality.However, contemporary outcomes and optimal secondary prevention strategies remain unclear. MethodsWe conducted a multicenter retrospective cohort study across eight UK transplant centers, identifying 136 kidney transplant recipients diagnosed with first-ever CSCC between 2016 and 2020. ResultsOver a median follow-up of 39 months, 48.5% developed further CSCC, and 23.3% died, most commonly from malignancy.Poor outcomes were confirmed in another, international, cohort.Management varied within and between UK centers and 28.7% underwent immunosuppression reduction, though specific approaches were inconsistent.Distinct clinical and histopathological features were associated with recurrence risk and poorer outcomes, including multiple index lesions, high-risk histopathology and current smoking. ConclusionThese findings confirm that contemporary post-CSCC outcomes remain unchanged from historic outcomes, despite advances in transplant care.The variability in management after first CSCC highlights the need for prospective studies to define effective interventions for secondary prevention.Importantly, we identify important clinical features present at first CSCC that may guide targeting of such interventions to the highest risk patients.

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Publication Details

Journal
Kidney International Reports
Published
2026-04-01
DOI
https://doi.org/10.1016/j.ekir.2026.106522
Citations
1
Primary Topic
Nonmelanoma Skin Cancer Studies
Type
article
Field-Weighted Citation Impact
18.84

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article

Clinical Equipoise and Unimproved Outcomes following Posttransplant Cutaneous Squamous Cell Carcinoma

Raj Thuraisingham, Nina Muirhead, Jeva Cernova, Buddhika Wijayawickrama et al.
1 citations
Kidney International Reports
Nonmelanoma Skin Cancer Studies
18.84
article

Clinical Equipoise and Unimproved Outcomes following Posttransplant Cutaneous Squamous Cell Carcinoma

Raj Thuraisingham, Nina Muirhead, Jeva Cernova, Buddhika Wijayawickrama, B. Solomon, Emily S. Ruiz, SIAN V. GRIFFIN, Emily Karn, A. Darvay, James P. Moriarty, Emilia Peleva, Maria Angela Gauci, Jonathan Gamble, Nitin Bhandary, Alex Owen, Tom Crisp, Farida Shah, Khizr Nawab, Elizabeth Wallin, Rabiah Ahmed, Harry Wakefield, C. A. Harwood, Rubeta Matin, Adarsh Babu, Philippa Bailey, Adnan Sharif, Rachel Abbott, Charles Archer, Matthew J. Bottomley
article en
1 citations

Abstract

IntroductionCutaneous squamous cell carcinoma (CSCC) is the most common malignancy following solid organ transplantation.Historical data suggest that 25% of kidney transplant recipients develop additional CSCC within a year of their first lesion, with significantly increased risks of metastasis and mortality.However, contemporary outcomes and optimal secondary prevention strategies remain unclear. MethodsWe conducted a multicenter retrospective cohort study across eight UK transplant centers, identifying 136 kidney transplant recipients diagnosed with first-ever CSCC between 2016 and 2020. ResultsOver a median follow-up of 39 months, 48.5% developed further CSCC, and 23.3% died, most commonly from malignancy.Poor outcomes were confirmed in another, international, cohort.Management varied within and between UK centers and 28.7% underwent immunosuppression reduction, though specific approaches were inconsistent.Distinct clinical and histopathological features were associated with recurrence risk and poorer outcomes, including multiple index lesions, high-risk histopathology and current smoking. ConclusionThese findings confirm that contemporary post-CSCC outcomes remain unchanged from historic outcomes, despite advances in transplant care.The variability in management after first CSCC highlights the need for prospective studies to define effective interventions for secondary prevention.Importantly, we identify important clinical features present at first CSCC that may guide targeting of such interventions to the highest risk patients.

Kidney International ReportsVol. 11(6)
Brigham and Women's Hospital (US), Cardiff and Vale University Health Board (GB), North Bristol NHS Trust (GB), University Hospitals Birmingham NHS Foundation Trust (GB), Queen Mary University of London (GB), Barts Health NHS Trust (GB), Angkor Hospital for Children (KH), Churchill Hospital (GB), Buckinghamshire Healthcare NHS Trust (GB), Royal Berkshire NHS Foundation Trust (GB), Nuffield Orthopaedic Centre (GB), Gloucestershire Hospitals NHS Foundation Trust (GB), Oxford University Hospitals NHS Trust (GB)
Wellcome Trust, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences Initiative for Innovative Medicine
Zero hunger
Openalex Percentile: Top 1%
Nonmelanoma Skin Cancer Studies
18.84
DOIOpen Access PDFOpenAlex
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