2026-04-13T01:54:39Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/125062025-10-24T10:16:23Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Bouwes Bavinck, Jan Nico author Genders, Roel author de Jong, Estella author Arron, Sarah author Gómez Tomás, Álvaro author González-Cruz, Carlos author Garcia-Patos Briones, Vicente author Ferrandiz-Pulido, Carla author 2025-01-31T09:11:20Z 2025-01-31T09:11:20Z 2023-01 Risk assessment; Skin cancer; Organ transplant recipient Avaluació del risc; Càncer de pell; Receptors de trasplantaments d'òrgans Evaluación del riesgo; Cáncer de piel; Receptores de trasplantes de órganos Importance: The Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) tool has been developed in the US to facilitate the identification of solid organ transplant recipients (SOTRs) at a higher risk of developing skin cancer. However, it has not yet been validated in populations other than the one used for its creation. Objective: To provide an external validation of the SUNTRAC tool in different SOTR populations. Design, setting, and participants: This retrospective external validation prognostic study used data from a prospectively collected cohort of European SOTRs from transplant centers at teaching hospitals in the Netherlands (1995-2016) and Spain (2011-2021). Participants were screened and followed up at dermatology departments. Data were analyzed from September to October 2021. Main outcomes and measures: The discrimination ability of the SUNTRAC tool was assessed via a competing risk survival analysis, cumulative incidence plots, and Wolbers concordance index. Calibration of the SUNTRAC tool was assessed through comparison of projected skin cancer incidences. Skin cancer diagnoses included squamous cell carcinoma, basal cell carcinoma, melanoma, and Merkel cell carcinoma. Results: A total of 3421 SOTRs (median age at transplant, 53 [quartile 1: 42; quartile 3: 62] years; 2132 [62.3%] men) were assessed, including 72 Asian patients (2.1%), 137 Black patients (4.0%), 275 Latinx patients (8.0%), 109 Middle Eastern and North African patients (3.2%), and 2828 White patients (82.7%). With a total of 23 213 years of follow-up time, 603 patients developed skin cancer. The SUNTRAC tool classified patients into 4 groups with significantly different risks of developing skin cancer during follow-up. Overall, the relative rate for developing skin cancer estimated using subdistribution hazard ratios (SHRs) and using the low-risk group as the reference group, increased according to the proposed risk group (medium-risk group: SHR, 6.8 [95% CI, 3.8-12.1]; P < .001; high-risk group: SHR, 15.9 [95% CI, 8.9-28.4]; P < .001; very-high-risk group: SHR, 54.8 [95% CI, 29.1-102.9]; P < .001), with a concordance index of 0.72. Actual skin cancer incidences were similar to those predicted by the SUNTRAC tool (5-year skin cancer cumulative incidence for medium-risk group: predicted, 6.2%; observed, 7.0%). Conclusions and relevance: The findings of this external validation prognostic study support the use of the SUNTRAC tool in European populations for stratifying SOTRs based on their skin cancer risk and also detecting patients at a high risk of developing skin cancer. This can be helpful in prioritizing and providing better screening and surveillance for these patients. http://hdl.handle.net/11351/12506 Pell - Càncer - Factors de risc Trasplantació d'òrgans, teixits, etc. Pell - Càncer - Diagnòstic NAMED GROUPS::Persons::Transplant Recipients ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Transplantation::Organ Transplantation Other subheadings::Other subheadings::Other subheadings::/adverse effects DISEASES::Neoplasms::Neoplasms by Site::Skin Neoplasms Other subheadings::Other subheadings::/diagnosis DENOMINACIONES DE GRUPOS::personas::receptores de trasplantes TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::evaluación de riesgos TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::trasplante::trasplante de órganos Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias cutáneas Otros calificadores::Otros calificadores::/diagnóstico External Validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a Large European Solid Organ Transplant Recipient Cohort