{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:34:27Z","timestamp":1785008067019,"version":"3.55.0"},"reference-count":103,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T00:00:00Z","timestamp":1550793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Organ transplant recipients (<jats:styled-content style=\"fixed-case\">OTR<\/jats:styled-content>) have a higher risk of developing cutaneous squamous cell carcinoma (<jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content>) compared to the immunocompetent population. Immunosuppression is often stated as a risk factor for metastasis. However, evidence for this is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> metastasis risk in <jats:styled-content style=\"fixed-case\">OTR<\/jats:styled-content> and the immunocompetent population by systematically reviewing the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was performed up to January 2018 using: Medline; Embase; Web of Science and <jats:styled-content style=\"fixed-case\">ISI<\/jats:styled-content> Science Citation Index. Studies assessing <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> metastasis risk in <jats:styled-content style=\"fixed-case\">ORT<\/jats:styled-content> or immunocompetent cohorts were considered. A pooled risk estimate for metastasis was calculated for the immunocompetent population and <jats:styled-content style=\"fixed-case\">OTR<\/jats:styled-content> separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pooled metastasis risk estimate for <jats:styled-content style=\"fixed-case\">OTR<\/jats:styled-content> was, respectively, 7.3% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 6.2\u20138.4) for <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> on total body, and 11.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.7\u201314.8) for <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> of the head neck area. For the immunocompetent population reported risk estimate analysis showed a pooled metastatic risk of 3.1% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.8\u20133.4) in total body <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> and of 8.5% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 7.3\u20139.8) in <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> of the head and neck area.<\/jats:p><jats:p>Pooled risk estimate per single <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">OTR<\/jats:styled-content> was 1.3% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.0\u20131.7) in total body <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> and 4.0% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.7\u20135.5) in <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> of the head and neck area. In the immunocompetent population, these pooled risk estimates were, respectively, 2.4% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.1\u20132.6) and 6.7% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 5.7\u20137.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Organ transplant recipients show a higher overall risk of <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> metastasis compared to the immunocompetent population. Metastasis risks per single <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> were substantially lower in both groups. However, due to heterogeneity and differences between studies, comparisons are difficult. Comprehensive follow\u2010up studies with defined cohorts are necessary to adequately asses the risk for <jats:styled-content style=\"fixed-case\">cSCC<\/jats:styled-content> metastasis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.15396","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T12:27:49Z","timestamp":1550838469000},"page":"828-841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Metastasis of cutaneous squamous cell carcinoma in organ transplant recipients and the immunocompetent population: is there a difference? a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"33","author":[{"given":"R.E.","family":"Genders","sequence":"first","affiliation":[{"name":"Department of dermatology Leiden University Medical Centre Leiden the Netherlands"},{"name":"Department of Dermatology Roosevelt Clinics Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.E.","family":"Weijns","sequence":"additional","affiliation":[{"name":"Department of dermatology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.M.","family":"Dekkers","sequence":"additional","affiliation":[{"name":"Department of clinical epidemiology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.I.","family":"Plasmeijer","sequence":"additional","affiliation":[{"name":"Department of dermatology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-9740.2004.02331.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200103293441306"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61196-X"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12988"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.01.003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.11.037"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.404"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2009.00555.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15324"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.07021.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.377"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000108491.62935.DF"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199003000-00006"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.11.062"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70178-5"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(92)70144-5"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09454.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2007.33190.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4425"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.08.033"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21898"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23155"},{"key":"e_1_2_6_24_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1001\/archderm.1990.01670260055010","article-title":"Squamous cell carcinoma. A population\u2010based incidence study in Rochester, Minn","volume":"126","author":"Chuang TY","year":"1990","journal-title":"Arch.Dermatol"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(89)70168-7"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199602000-00009"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.07.031"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.03.006"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2006.00218.x"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20576"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000246783"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970301)79:5<915::AID-CNCR7>3.0.CO;2-A"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.4994"},{"key":"e_1_2_6_34_1","first-page":"5","article-title":"Squamous cell carcinoma in organ transplant recipients: approach to management","volume":"9","author":"Carucci JA","year":"2004","journal-title":"Skin Therapy Letter"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990415)85:8<1758::AID-CNCR16>3.0.CO;2-F"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2004.30151.x"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.139.3.301"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2004.30149.x"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1990.tb03963.x"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)80326-2"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_6_42_1","unstructured":"WellsGA SheaB O'ConnellD PetersonJ WelchVet\u00a0al.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses2011. URLhttp:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp(last accessed: 25 November 2012)."},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19931001)72:7<2186::AID-CNCR2820720720>3.0.CO;2-2"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199603150-00008"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2017.4506"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000209921.60305.d9"},{"key":"e_1_2_6_47_1","first-page":"586","article-title":"Squamous and basal cell carcinoma in heart transplant recipients","volume":"17","author":"Lampros TD","year":"1998","journal-title":"J Heart Lung Transplant"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181ec7228"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.1998.tb00383.x"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12129"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2017.01.035"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70525-6"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)30524-1"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20164891"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200008000-00006"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23283"},{"key":"e_1_2_6_57_1","first-page":"1275","article-title":"Development of Malignancy Following Renal\u2010Transplantation in Australia and New\u2010Zealand","volume":"24","author":"Sheil AGR","year":"1992","journal-title":"Transpl Proc"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2001.1119"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198208000-00005"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198408000-00016"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-197706000-00022"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-8140(93)90006-T"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-6-73"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(98)90001-5"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2004.02.009"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850901)56:5<1099::AID-CNCR2820560524>3.0.CO;2-R"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2013.08.018"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1992.tb07065.x"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2017.02.013"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.2000.01827.x"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0309"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2013-304434"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2006.02569.x"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2010.01850.x"},{"key":"e_1_2_6_75_1","first-page":"279","article-title":"Squamous cell carcinomas of the skin of the pinna","volume":"18","author":"Shiffman NJ","year":"1975","journal-title":"Can.J Surg."},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.102673"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26704"},{"key":"e_1_2_6_78_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjom.2000.0584"},{"key":"e_1_2_6_79_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000110"},{"key":"e_1_2_6_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10227-001-0126-6"},{"key":"e_1_2_6_81_1","doi-asserted-by":"publisher","DOI":"10.1159\/000254001"},{"key":"e_1_2_6_82_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9098(199602)61:2<124::AID-JSO6>3.0.CO;2-E"},{"key":"e_1_2_6_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(84)90385-4"},{"key":"e_1_2_6_84_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1997.03890420073008"},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(195711\/12)10:6<1162::AID-CNCR2820100612>3.0.CO;2-F"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000000390"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.02.046"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1979.04010060011017"},{"key":"e_1_2_6_89_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24707"},{"key":"e_1_2_6_90_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000488"},{"key":"e_1_2_6_91_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000120181.89206.54"},{"key":"e_1_2_6_92_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767080-00006"},{"key":"e_1_2_6_93_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40618-3_15"},{"key":"e_1_2_6_94_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2017.3960"},{"key":"e_1_2_6_95_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.48.5326"},{"key":"e_1_2_6_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(88)80232-6"},{"key":"e_1_2_6_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.08.055"},{"key":"e_1_2_6_98_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.6.758"},{"key":"e_1_2_6_99_1","first-page":"39","article-title":"Management of high\u2010risk cutaneous squamous cell carcinoma","volume":"3","author":"Jennings L","year":"2010","journal-title":"J Clin Aesth Dermatol"},{"key":"e_1_2_6_100_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.09.035"},{"key":"e_1_2_6_101_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90245-1"},{"key":"e_1_2_6_102_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1708701"},{"key":"e_1_2_6_103_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2901"},{"key":"e_1_2_6_104_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.06.010"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdv.15396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.15396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.15396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.15396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T15:39:36Z","timestamp":1694360376000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.15396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,22]]},"references-count":103,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/jdv.15396"],"URL":"https:\/\/doi.org\/10.1111\/jdv.15396","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,22]]},"assertion":[{"value":"2018-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}