Cutaneous Squamous Cell Carcinoma in Immunocompromised Patients-A Comparison between Different Immunomodulating...

Area of Science:

• Dermatology
• Oncology
• Immunology

Background:

• Immunosuppression is a known risk factor for developing cutaneous squamous cell carcinoma (cSCC).
• Previous studies highlighted increased cSCC risk in solid organ transplant recipients (SOTR) and chronic lymphocytic leukemia (CLL) patients.
• Research on other immunosuppressed groups is limited, necessitating a comprehensive comparison.

Purpose of the Study:

• To assess the impact of various immunosuppressive conditions on cSCC patient outcomes.
• To compare clinical features, treatments, and survival rates across different immunosuppressed (IS) groups and immunocompetent controls.
• To identify high-risk patient populations for aggressive cSCC.

Main Methods:

• Retrospective analysis of 465 cSCC patients, including immunosuppressed and immunocompetent individuals.
• Investigated immunosuppression etiologies such as SOTR, CLL, chronic kidney disease (CKD), psoriasis, rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE).

Main Results:

• IS patients exhibited higher rates of positive resection margins, recurrence, and multiple cSCC tumors compared to controls.
• SOTR patients had the highest incidence of multiple cSCC tumors, while CKD patients showed the worst survival rates.
• CLL patients had elevated positive margin rates and required more oncological treatments; RA and psoriasis patients had shorter disease-free survival.

Conclusions:

• Immunosuppression from SOTR, CLL, CKD, RA, and psoriasis is linked to poorer cSCC outcomes.
• These patient groups are at high risk for aggressive cSCC development and require close monitoring.
• This study provides the first comparative analysis of cSCC outcomes across multiple immunosuppressed patient cohorts.