Browsing by Author "Piaserico, S."

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    Clinicopathological features, MCPyV status and outcomes of Merkel cell carcinoma in solid-organ transplant recipients: a retrospective, multicentre cohort study
    (2022) Ferrandiz-Pulido, C.; Gomez-Tomas, A.; Llombart, B.; Mendoza, D.; Marcoval, J.; Piaserico, S.; Baykal, C.; Bouwes-Bavinck, J.N.; Racz, E.; Kanitakis, J.; Harwood, C.A.; Cetkovska, P.; Geusau, A.; Del Marmol, V; Masferrer, E.; Cano, C.Orte; Ricar, J.; de Oliveira, W.R.; Salido-Vallejo, R.; Ducroux, E.; Gkini, M.A.; Lopez-Guerrero, J.A.; Kutzner, H.; Kempf, W.; Seckin, D.; 35607918
    Background The proportion of Merkel cell carcinomas (MCCs) in solid-organ transplant recipients (SOTR) harbouring Merkel cell polyomavirus (MCPyV) is unknown, as are factors affecting their outcomes. Objective To describe clinicopathological features of MCC in SOTR, investigate the tumoral MCPyV-status and identify factors associated with tumour outcomes. Methods Retrospective, international, cohort-study. MCPyV-status was investigated by immunohistochemistry and polymerase chain reaction. Results A total of 30 SOTR and 44 consecutive immunocompetent patients with MCC were enrolled. SOTR were younger at diagnosis (69 vs. 78 years, P < 0.001). Thirty-three percent of SOTR MCCs were MCPyV-positive vs. 91% of immunocompetent MCCs (P = 0.001). Solid-organ transplantation was associated with an increased cumulative incidence of progression (SHR: 3.35 [1.57-7.14], P = 0.002), MCC-specific mortality (SHR: 2.55 [1.07-6.06], P = 0.034) and overall mortality (HR: 3.26 [1.54-6.9], P = 0.002). MCPyV-positivity and switching to an mTOR inhibitor (mTORi) after MCC diagnosis were associated with an increased incidence of progression (SHR: 4.3 [1.5-13], P = 0.008 and SHR: 3.6 [1.1-12], P = 0.032 respectively) in SOTR. Limitations Retrospective design and heterogeneity of SOTR cohort. Conclusions MCPyV appears to play a less prominent role in the aetiopathogenesis of MCC in SOTR. SOTR have a worse prognosis than their immunocompetent counterparts and switching to an mTORi after the diagnosis of MCC does not improve progression.
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    Painful skin lesions and squamous cell carcinoma predict overall mortality risk in organ transplant recipients: a cohort study
    (2017) Seckin, D.; Oh, C.C.; Hofbauer, G.F.L.; Serra, A.L.; Harwood, C.A.; Mitchell, L.; Proby, C.M.; Olasz, E.B.; Mosel, D.D.; Piaserico, S.; Fortina, A.B.; Geusau, A.; Jahn-Bassler, K.; Gerritsen, M. J. P.; Gulec, A.T.; Cetkovska, P.; Ricar, J.; Imko-Walczuk, B.; Debska-Slizien, A.; Bavinck, J. N. Bouwes; 28012178
    BackgroundOrgan transplant recipients (OTRs) have a highly increased risk of cutaneous squamous cell carcinomas (SCCs). Sensation of pain in cutaneous tumours is a powerful patient-reported warning signal for invasive SCCs in OTRs. ObjectivesTo investigate the impact of painful vs. painless skin lesions and SCC vs. other skin lesions on the overall mortality risk in OTRs. MethodsWe followed 410 OTRs from 10 different centres across Europe and North America between 2008 and 2015. These patients had been enrolled in an earlier study to define clinically meaningful patient-reported warning signals predicting the presence of SCC, and had been included if they had a lesion requiring histological diagnosis. Cumulative incidences of overall mortality were calculated using Kaplan-Meier survival analysis, and risk factors were analysed with Cox proportional hazard analysis. ResultsThere was an increased overall mortality risk in OTRs who reported painful vs. painless skin lesions, with a hazard ratio (HR) of 16 [95% confidence interval (CI) 097-27], adjusted for age, sex and other relevant factors. There was also an increased overall mortality risk in OTRs diagnosed with SCC compared with other skin lesions, with an adjusted HR of 17 (95% CI 10-28). Mortality due to internal malignancies and systemic infections appeared to prevail in OTRs with SCC. ConclusionsWe suggest that OTRs have an increased overall mortality risk if they develop painful skin lesions or are diagnosed with cutaneous SCC.