A narrative review on the outcome of primary cutaneous melanomas arising in solid organ transplant recipients

Abstract

Chronic immunosuppression is a risk factor for cutaneous melanoma, as indicated by the increased incidence among solid organ transplant recipients (OTRs). The outcome of post-transplant melanomas has not frequently been investigated. The aim of this narrative review was to investigate overall survival (OS) and melanoma-specific mortality (MSM) of primary cutaneous melanomas (CM) among OTRs compared to the outcome of cutaneous melanomas arising in immunocompetent patients. A systematic literature search was conducted in PubMed to identify studies reporting on primary CM among OTRs and their outcome. The search was restricted to the English language and included investigations through to April 1^st, 2019. Of the seven articles included, all except one reported a lower OS for primary CM among OTRs compared to immunocompetent patients. In these six investigations, MSM was increased, but not relative to Clark level, Breslow thickness or American Joint Committee on Cancer (AJCC) stage. A lower OS can be expected among OTRs with primary CM. There is still much heterogeneity in MSM adjusted for Breslow thickness, AJCC staging and Clark level, with no conclusive answers. Prospective studies are needed to clarify MSM for this specific patient group.

Keywords: melanoma; melanoma specific mortality; melanoma-specific survival; organ transplant recipients; overall survival; solid organ transplantation.