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Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional

Autores: Miñano Medrano, R. (Autor de correspondencia); López Estebaranz, J. L.; Sanmartín-Jiménez, O.; Garcés, J. R.; Rodríguez-Prieto, M. A.; Vilarrasa-Rull, E.; De Eusebio-Murillo, E.; Escutia-Muñoz, B.; Flórez-Menéndez, A.; Artola-Igarza, J. L.; Alfaro-Rubio, A.; Redondo Bellón, Pedro; Delgado-Jiménez, Y.; Sánchez-Schmidt, J. M.; Allende-Markixana, I.; Alonso-Pacheco, M. L.; García-Bracamonte, B.; De la Cueva-Dobao, P.; Navarro-Tejedor, R.; Ciudad-Blanco, C.; Carnero-González, L.; Vázquez-Veiga, H.; Cano-Martínez, N.; Ruiz-Salas, V.; Sánchez-Sambucety, P.; Botella-Estrada, R.; González-Sixto, B.; Martorell-Calatayud, A.; Gil Sánchez, María Pilar; Morales-Gordillo, V.; Toll-Abello, A.; Ocerin-Guerra, I.; Mayor-Arenal, M.; Suárez-Fernández, R.; Sainz-Gaspar, L.; Descalzo, M. A.; García-Doval, I.
Título de la revista: ACTAS DERMO-SIFILIOGRAFICAS
ISSN: 0001-7310
Volumen: 113
Número: 5
Páginas: 451 - 458
Fecha de publicación: 2022
Resumen:
Objective: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Material and methods: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. Results: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%) vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and mate sex (RR, 1.6; 95% CI, 1.4-1.9). Conclusion: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.
DOI: https://doi.org/10.1016/j.ad.2022.01.003
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