Nonmelanotic Skin Cancer Research Articles

#1960 Incidence of cancer in ANCA associated vasculitis (AAV)

Abstract Background and Aims We investigated the incidence rate and type of cancer in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in our Institute. Method We retrospectively included 210 patients with AAV [106 patients with microscopic polyangiitis (MPA), 93 with granulomatosis with polyangiitis (GPA) and 11 patients with eosinophilic GPA (EGPA)], and reviewed their medical records. We collected demographic, clinical and laboratory data. We selected patients with history of cancer, patients diagnosed with paraneoplastic AAV and patients who developed malignant disease after AAV. We reviewed the use of glucocorticoid and immunosuppressive drugs. Results Between 1993-2024 there were 16 patients with AAV who had cancer during their life in our Department. There were eight patients with malignancy-associated AAV. Two patients were simultaneously diagnosed with kidney carcinoma and vasculitis. One patient's serum was positive for cytoplasmatic ANCA, the other patient's for pANCA. Complete resection of cancer and renal biopsy was performed, they got steroid monotherapy. Five patients were diagnosed with pANCA vasculitis a few months (1-5) after the diagnosis of malignancies (two pts with breast carcinoma, two pts with ovarium carcinoma, one patient with ventricular carcinoma). In one case the pAAV was established after 5 months of oropharyngeal tumor's resection. Two patients had history of malignancy (one pts had colon carcinoma 4 ys before the appearance of AAV, the other patient had breast carcinoma 10 ys before the AAV). In both cases there were examinations for malignancy with negative results. In these cases the vasculitis was not associated with carcinoma. The therapeutic approach included the use of corticosteroids, plasmapheresis, and cyclophosphamide or rituximab. Six patients were observed malignancy 0.5-10 years after the diagnosis of AAV. There was one pancreas, one ventricular, two lung and two bladder carcinoma. Conclusion In our study we focused on the relationship of malignancy and AAV. Between the 210 patients with AAV eight cases (3.8%) were malignancy-associated, in one case cANCA associated, the other cases pANCA was presented. Treating paraneoplastic vasculitis can be challenging. Individualized treatment strategy tailored to patients' needs is crucial. Six patients were diagnosed with solid tumor during the follow-up. The cumulative overall cancer incidence rates were 1.4% and 2.8% at 5 and 10 years, respectively. Only in one patient with bladder cancer was treated with the cumulative CYC doses ≥ 36 g. No leukemia or non melanotic skin cancer (NMSC) was represented contrary to other studies.

Assessing the Feasibility and Effectiveness of Screening for Indoor Tanning in the Primary Care Setting: A Report of Preliminary Findings

Introduction: Indoor tanning is a major modifiable risk factor in the development of both melanontic and non-melanotic skin cancers. Investigation of behavior-altering interventions is an area of active research. As with other preventative measures, screening of high-risk populations can be an important aspect of a multimodality public health intervention. We sought to further the limited understanding of indoor tanning screening practices in the primary care setting.Methods: Physicians practicing within the scope of primary care in the northeast were surveyed in 2022 on practice patterns around frequency of indoor tanning screening, barriers encountered with implementing screening, and actions taken with a positive screen. Research methodology adhered to the Joanna Briggs Institute research study critical appraisal checklist.Results: Of 26 primary care physicians (PCPs), only 7.7% routinely screened for indoor tanning. Barriers identified included time limitations (76.9%) and prioritization of other health concerns (96.2%). All PCPs (100%) reacted to reports of indoor tanning with an intervention, most commonly counseling on the risks of indoor tanning (92.6%).Conclusions: Our data suggests that screening for indoor tanning use could be improved. We recommend the incorporation of a standardized screening question regarding indoor tanning in intake forms.

Nonmelanoma facial skin cancer: surgical planning for resection and reconstruction

Introduction The most effective treatment for nonmelanotic fascial skin cancer is surgical excision. Preoperative planning and a thorough grasp of reconstructive procedures, such as primary closure skin grafting, locoregional tissue flaps, remote tissue flaps, and free tissue transfer, are essential for the surgical therapy of these tumors. The choice of nonmelanoma skin cancer (NMSC) therapy is very specific to each patient and is influenced by the patient’s age, size, histologic subtype, and location of the disease. Treatment is to obliterate the lesion while maintaining normal tissue, function, and appearance. The ideas and methods of surgical excision and reconstruction of skin malignancies unique to the face were covered in this study. Patients and methods This study involved 98 patients of various ages and sexes. Of them, 89% had basal cell carcinoma and 11% had squamous cell carcinoma, both low-and high-risk tumors with varying sizes, locations, and histological subtypes. A safety margin of 3–5 mm is used for excision of low-risk malignancies and 5–10 mm for high-risk cancers. In 17 patients, skin grafts (split-thickness skin grafts and full-thickness skin grafts) are employed. 56 patients underwent local advancement, transposition, and rotational flaps; 15 patients underwent regional interpolation flaps; 6 patients sustained neck lymph node infiltration so they underwent cervical block dissection and distant pedicled flaps as latissimus dorsi muscle flaps; and 4 patients underwent cervical block dissection and free tissue transfer. Results Six patients experienced problems in the form of two partial graft and flap losses, two wound infections, and one scar retraction; however, with targeted care, they recovered well. Ninety-two percent of patients found the cosmetic outcomes satisfactory, and the functional outcome was good. Conclusion Wide excision and appropriate surgical reconstruction are ideal treatment modalities and may yield good aesthetic results or functional outcome, also the use of split-thickness skin grafts does not come as a first priority, where a lot of cases could have been treated with local flaps, as demonstrated in this consecutive series of treated patients. Treatment of NMSC on the face required a basic knowledge, presents a challenge to plastic surgeons, and is based on achieving the best oncological, functional, and cosmetic result. It is crucial to emphasize the need of patient education and appropriate tumor monitoring after NMSC therapy. A review of a big series of facial malignancy that may guide further studies cannot be understated.

Associations Between Social Determinants of Health and Cardiovascular Health of U.S. Adult Cancer Survivors

BackgroundRelationships between the social determinants of health (SDOH) and cardiovascular health (CVH) of cancer survivors are underexplored. ObjectivesThis study sought to investigate associations between the SDOH and CVH of adult cancer survivors. MethodsData from the U.S. National Health Interview Survey (2013-2017) were used. Participants reporting a history of cancer were included, excluding those with only nonmelanotic skin cancer, or with missing data for any domain of SDOH or CVH. SDOH was quantified with a 6-domain, 38-item score, consistent with the Centers for Disease Control and Prevention recommendations (higher score indicated worse deprivation). CVH was quantified based on the American Heart Association’s Life’s Essential 8, but due to unavailable detailed dietary data, a 7-item CVH score was used, with a higher score indicating worse CVH. Survey-specific multivariable Poisson regression was used to test associations between SDOH quartiles and CVH. ResultsAltogether, 8,254 subjects were analyzed, representing a population of 10,887,989 persons. Worse SDOH was associated with worse CVH (highest vs lowest quartile: risk ratio 1.30; 95% CI: 1.25-1.35; P < 0.001), with a grossly linear relationship between SDOH and CVH scores. Subgroup analysis found significantly stronger associations in younger participants (Pinteraction = 0.026) or women (Pinteraction = 0.001) but without significant interactions with race (Pinteraction = 0.051). Higher scores in all domains of SDOH were independently associated with worse CVH (all P < 0.001). Higher SDOH scores were also independently associated with each component of the CVH score (all P < 0.05 for highest SDOH quartile). ConclusionsAn unfavorable SDOH profile was independently associated with worse CVH among adult cancer survivors in the United States.

The Long-Term Outcome of Kidney Transplant Recipients in the Eighth Decade Compared With Recipients in the Seventh Decade of Life

With the aging of the population, more older patients are being considered for kidney transplantation; therefore, it is crucial to evaluate the risks and benefits of transplantation in this population. This study aimed to assess long-term outcomes of kidney transplantation in a cohort of patients who underwent kidney transplantation at age >70 years, compared with patients aged 60 to 69 years at transplantation. Included in the study were 261 consecutive kidney transplant recipients: 52 were aged >70 years, and 209 were aged 60 to 69 years at transplantation. Data were collected retrospectively and analyzed using multivariate logistic regression to identify potential outcome risk factors. The number of transplants in both groups increased during the study period. Mortality after transplantation was strongly correlated to age (hazard ratio [HR]=1.11; 95% CI, 1.05-1.18; P < .001), deceased donor (HR=2.0; 95% CI, 1.1-3.8; P=.034), and pretransplant diabetes (HR=2.9; 95% CI, 1.7-4.9; P=.001). Recipients aged >70 years had an increased risk of death censored graft failure (HR=2.98; 95% CI, 1.56-5.74; P=.001). In living donor transplants, 3-year survival was 80% in recipients age >70 years, compared with 98% in the 60- to 69-year group. Five-year survival was 71% and 92%, respectively. In deceased donor transplants, 3-year survival was 63% and 78%, and 5-year survival was 58% and 72%, respectively. The risk of malignancy (excluding nonmelanotic skin cancer) was nearly triple in the age >70 years group (HR=2.96; 95% CI, 1.3-6.8; P=.01). Patient and graft survival in kidney recipients in the eighth decade is worse compared with recipients in the seventh decade of life. However, it is improved with living kidney donation.

73. [LDQUO]Ignorance is bliss[RDQUO]…Non-melanotic skin cancer service (NMSC): Are we meeting the core and non-core clinical dataset requirements on our histopathology reports?

The provision of accurate clinical information is the responsibility of the surgeon submitting a specimen for pathological assessment. The requirement for clinical information is based on the proposed UK National Histopathology Request Form and Cancer Outcomes and Services Dataset (COSD).

Second Primary Malignancy in Waldenström Macroglobulinemia: Insights from a Population-Based Analysis

INTRODUCTION: Waldenström Macroglobulinemia (WM), is a hyper-viscosity syndrome characterized by unrestricted proliferation of lymphoplasmacytic precursors in the bone marrow and monoclonal IgM gammopathy. The development of secondary primary malignancy (SPMs) in WM is a multifactorial phenomenon; the indolent nature of the disease, associated immune dysregulation, environmental factors and therapeutic measures, are responsible for high incidence of SPM in WM. This study was conducted to analyse the site-specific incidence of SPM in WM using data from the US Surveillance, Epidemiology and End Results (SEER) cancer registries. METHODS: A retrospective study was conducted using the SEER-18 dataset. WM patients who were diagnosed between 2000 and 2018, according to the ICD-O-3 = 9761/3 were included. Patients diagnosed on autopsy or through death certificates, and patients with incomplete follow-up data were excluded. SPM was defined as other malignancy appearing at least 1 year after WM diagnosis. Latency was defined as interval between WM and SPM diagnosis. Standardized incidence ratios (SIRs) and absolute excess risks (AERs) were calculated using SEER*Stat software (version 8.3.9). P-values and 95% confidence intervals (CI) were generated assuming Poisson distribution of observed incidence of SPM. RESULTS: A total of 4112 WM patients were identified. SPM was reported in 699 (17.0%) patients. The overall risk of developing SPM was significantly higher in WM patients as compared to the general population (SIR= 1.53, 95% CI=1.42-1.65, p <0.05) with an AER of 102.69 per 10,000 population. The risk of developing second primary solid tumors was significantly greater compared to the general population (SIR = 1.12, 95% CI= 1.02-1.23, p >0.05), but significantly increased risks were reported for secondary tumours of the lung and bronchus (SIR = 1.44), skin melanoma (SIR = 1.88), mouth (SIR 3.28), brain (SIR 2.73) and non-melanotic skin tumors (SIR = 4.09). The overall risk of developing secondary hematological malignancies was significantly increased (SIR = 4.95, 95% CI 4.31-5.66, p <0.05). Significantly increased risks were reported for nodal non-Hodgkin lymphoma (NHL) (SIR = 6.62), extranodal NHL (SIR = 11.3), acute lymphocytic leukemia (ALL) (SIR 8.04), acute non-lymphocytic leukemia (ANLL) (SIR = 4.2) and acute myeloid leukemia (AML) (SIR 4.22). Increased risk of SPMs was noted for patients with age 50-74 years (SIR= 1.65, 95%CI=1.44-1.89, p value <0.05) or > 75 years (SIR= 1.3, 95% CI= 1.13-1.49, p value <0.05), but not for patients younger than 50 years. Patients aged 50-74 years had a significantly increased risk of developing SPMs of lungs and bronchus (SIR 2.23), skin (SIR 3.09), vulva (SIR 8.5), thyroid (SIR 3.59), nodal NHL (SIR 6.06), extranodal NHL (SIR 11.87), ANLL (SIR 5.77) and AML (SIR 6.37). Patients aged >75 years had a significantly increased risk of developing SPMs of cecum (SIR 2.50), colon (SIR 1.62), soft tissues (SIR 5.25), nodal NHL (SIR 2.38), extranodal NHL (SIR 7.51), ANLL (SIR 3.69) and AML (SIR 3.63). Risk of SPM was significantly increased in both males (SIR 1.39) and females (SIR 1.59). On subsite evaluation, males had a significantly greater risk of SPMs involving lung and bronchus (SIR 1.71), soft tissues (SIR 4.52), skin (SIR 1.88), nodal NHL (SIR 3.85), extra-nodal NHL (SIR 6.9), ANLL (SIR 5.4) and AML (SIR 5.55). Females reported a significantly increased risk of SPM involving cecum (SIR 3.88), skin (SIR 2.87), vagina (SIR 11.51) nodal NHL (SIR 3.86) and extranodal NHL (SIR 13.57). The risk of SPM was significantly greater in Caucasians (SIR 1.46) but not African Americans or other races. The risk of SPM was significantly greater in patients at all latencies. The risk of SPM of cecum (SIR 2.76) and non-melanotic skin cancer (SIR 5.52) was significantly greater in patients with latency of 12-59 months, but not at subsequent latencies. The risk of melanotic skin cancer (SIR 2.61) was significantly greater in patients with latency of 60-119 months but not other latencies. The risk of thyroid cancer (SIR 6.43) was significantly increased for patients with latency 120+ months only. CONCLUSION: This study showed that 17% of WM patients developed SPM. WM patients were at a 53% greater risk of developing SPM compared to the general population. Caucasians and patients aged greater than 50 years were at particularly high risk of developing SPM. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The use of HCT and/or ACE inhibitors significantly increases the risk of non-melanotic skin cancer in the periocular region

Background/AimsTo investigate a possible association between the use of hydrochlorothiazide (HCT) and/or angiotensin-converting enzyme inhibitors (ACE inhibitors) and the occurrence of periocular non-melanoma skin cancer.MethodsThe files of 929 patients from the University Medical Center Hamburg-Eppendorf who were surgically treated for suspected periocular malignancy were evaluated retrospectively regarding the occurrence of non-melanoma skin cancer and concomitant medication. To be able to put the data in an overall context, we also analyzed age-matched routine data of the DAK-Gesundheit (DAK-G), a nationwide operating German health insurance company.ResultsOf the 929 patient records examined, who underwent surgical excision for suspected non-melanotic malignancy, non-melanocytic skin cancer could actually be determined by histology in 199 patients. In total, 176 patients (103 women, 72 men) had a basal cell carcinoma and 23 patients (16 women, 7 men) suffered from squamous cell carcinoma. The rate of intake of HCT or ACE inhibitors in our patient collective with non-melanotic skin cancer is significantly higher than in the general age-matched population (ORACE: 2.51, p < 0.001; ORHCT: 7.24, p < 0.001, ORBOTH: 4.61, p < 0.001).ConclusionThe rate of intake of HCT or ACE inhibitors is significantly higher in our patient collective with non-melanotic skin cancer compared to the group from the age-matched general population (DAK insured (p < 0.001)) compared to the routine data of the DAK-G. This leads us to the conclusion that taking the medication is associated with an increased risk for non-melanotic skin cancer. We recommend regular skin cancer screening, moderate ordination of photosensitizing medication, but above all comprehensive clarification of possible risks.

P515 Inflammatory bowel disease and malignancy – the outcome of patients with malignancy diagnosed before IBD diagnosis or IBD-targeted therapy

Abstract Background The treatment strategy in IBD patients with previous malignancy is not well defined, and the available literature is scarce.The main aim of this study was to describe the outcome of IBD patients with previous malignancy or before exposure to IBD-related treatment. Methods The study cohort included IBD patients with at least one malignancy diagnosed before IBD or before initiation of IBD-related treatment (excluding 5-ASA/corticosteroids). All patients were followed at the department of gastroenterology in Sheba medical center between 2010 and 2021. Clinical and demographic data were extracted from the patients’ medical records. The main outcome of interest was a relapse of previous malignancy or the development of a second malignancy. Results From our IBD database comprising 3811 patients, we identified 86 patients with malignancy before IBD-related treatment: 38 diagnosed with malignancy 6 years before IBD (median time, IQR=3–12) and 48 - after (15 years (IQR7-22) IBD diagnosis but before exposure to IBD treatment. The most common malignancy preceding IBD was breast cancer found in 9/38 (24%) patients. Other malignancies before IBD diagnosis included: lymphoma 7/38 patients (18%), melanoma in 6 patients (16%), and leukemia in 4 patients (11%). After a diagnosis of IBD, 38/86 (44%) patients were treated with thiopurines, 28/86 (32%) with vedolizumab (VDZ), and 26/86 (30%) with anti-TNFs. 10/86 (9%) patients were further diagnosed with second primary malignancy. The median time from first to second malignancy was 7 years (IQR=16-6); 7/10 patients (70%) were exposed to thiopurines, 6/10 (60%) to anti-TNFs, and 6/10 (60%) to VDZ. The only clinical variable associated with second malignancy was female gender (9/40 (22.5%) vs. 1/46 (2.2%), p=0.005). 20/86 patients (23%) had a recurrence of malignancy (median- 3 years (IQR=3–9). The most common recurrent malignancies were non-melanotic skin cancer (NMSC) In 9 patients (45%) and melanoma in 3 patients (20%). Of patients with recurrence, 11 patients (55%) were exposed to thiopurines, 10 patients (50%) were exposed to anti-TNFs, and 5 patients (25%) were exposed to vedolizumab. Treatment with anti-TNFs was associated with recurrence of NMSC (6/25 (24%) vs. 2/52 (3.7%), p=0.047). Conclusion In our retrospective tertiary center cohort, recurrence of malignancies in IBD patients with previous neoplasia was uncommon. However, most recurrent malignancies were solid and hematopoietic malignancies. Female gender was associated with an increased risk of second malignancy, while anti-TNF treatment was associated with an increased risk of NMSC recurrence. Our findings underline the importance of rigorous dermatological follow-up in IBD patients with previous NMSC treated with anti-TNFs

Micronodular basal cell carcinoma of the scrotum: a case report and review of the literature

IntroductionBasal cell carcinoma is the most common nonmelanotic skin cancer. It has variable clinical and histological subtypes that vary in their aggressiveness and liability to recurrence and metastasis. Chronic ultraviolet radiation exposure is considered to be the main risk factor for developing basal cell carcinoma; therefore, it typically arises on sun-exposed skin, mainly the head and neck.Case presentationWe present the case of a 55-year-old Caucasian male who presented with a lesion on the scrotum for 2 years. The lesion was clinically presumed benign and initially treated with curettage. Microscopic examination revealed an incompletely resected micronodular basal cell carcinoma with sebaceous differentiation. Therefore, a second excisional biopsy was performed to completely excise the incidentally discovered malignant tumor.ConclusionWe report the first case of micronodular basal cell carcinoma arising on the scrotum. The goal of our article is to draw clinicians’ attention to the possible involvement of unexposed skin with basal cell carcinoma, and we highlight the importance of accurate diagnosis and prompt treatment due to the aggressive nature of micronodular basal cell carcinoma.

Cutaneous Malignancies After Kidney and Simultaneous Pancreas-Kidney Transplantations

Organ transplant recipients are at increased risk of nonmelanotic skin cancers (NMSC). Scarce data exist regarding secondary malignancies developing post-simultaneous pancreas-kidney (SPK) transplantations. Our aim was to assess long-term risk of skin cancers among kidney alone (KA) and SPK transplantation recipients. In this study, 521 patients who underwent KA or SPK transplantation at our medical center were observed up by dedicated nephrologists and dermatologists. SPK transplantation recipients were matched with a control group of KA transplantation recipients based on demographic and clinical data. A multivariate analysis was performed to find independent cancer risk factors. Patients who developed skin cancer were generally older, had a fair skin type, and had a higher incidence of NMSC before transplantation. Older age and fair skin type were independent risk factors on multivariate analysis. SPK transplantation in itself was not an independent risk factor. Cancer recurrence was associated with older age and male sex. Darker skin type and lowered immunosuppressive burden were protective. In contrast to previous studies, the use of antithymocytic agents or SPK transplantation were not independently associated with increased skin cancer risk in this multivariate analysis. These findings emphasize the complex interplay between posttransplantation NMSC and various clinical and epidemiologic risk parameters.

Clinical Pattern, Morphology and Treatment Modality of Basal Cell Carcinoma of Head and Neck Region: Analysis of 10 Cases

Basal cell carcinoma is most common type of non-melanotic skin cancer. Causative agents are UV and ionizing radiation and chemicals. Nodular, pigmented, superficial, cystic and infiltrative are major subtypes. It is mainly treated by excision surgery in the form of wide local excision and reconstruction is done by various flaps. In our study 10 patients were included and found that carcinoma is commoner in old age female patients and mainly near right canthus of eyeball; treated with surgery which is well tolerated by all the patients.

POS-690 Outcomes of Malignancy in Kidney Transplant Recipients

Malignancy, cardiovascular events, and infections are the leading causes of death among kidney transplant (KT) recipients. The risk of cancer in KT recipient is two to 4 folds increased than general population with reported higher mortality rates. Post-transplant malignancies can be related to de novo development, donor-related transmission, and recurrence of a recipient’s pre-transplant malignancy. Common malignancies post kidney transplantation are non-melanotic skin cancer, Kaposi sarcoma, post-transplant lym­phoproliferative disorder (PTLD), renal cell carcinoma (RCC), and anogenital cancer.

Abstract OT-14-01: Adaption of the EORTC quality of life breast cancer module for male breast cancer - phase I

Abstract Background: Approximately 1% of all new cases of breast cancer (BC) occur in men. Care of male BC is largely based on extrapolation from treatment strategies and management of symptoms in women. The impact of BC diagnosis and therapy on Quality of Life (QoL) in women with BC is well documented. Comprehensive, prospective data about QoL in men treated for BC are sparse. Due to the lack of a validated male BC QoL questionnaire, we previously evaluated the QoL of the male BC using the original EORTC QLQ-C30 and breast module QLQ BR23 with “female” items replaced by male-specific items from the EORTC QoL prostate module (EORTC QLQ-PR25). The development of a validated worldwide questionnaire for male BC is sponsored by EORTC QoL Group and will be completed in cooperation with EORTC Breast Group and the International Male BC Program (a cooperation between EORTC-BCG, TBCRC, within the BIG and NABCG networks) Trial design: The evaluation of the QoL issues relevant for male BC, as well as the translation of issues into items to build the tool for QoL assessment in male BC will be carried out through four phases: 1. A systematic Literature review 2. Interviews with patients 3. Interviews with Health Care Professionals (HCP) 4. Consultation of experts in Oncology and QoL Inclusion criteria: • Histologically proven early BC or metastatic BC in male patients • Age ≥ 18 years • Ability to understand and fill out questionnaires • Written informed consent Exclusion criteria: • Other cancer in the past 5 years except non-melanotic skin cancer • Patients participating in interventional clinical studies with QoL as primary endpoint • Any condition potentially hampering compliance with the study protocol Aims: The study proposes to carry out an evaluation of the QoL issues relevant for male patients with BC, and translating the issues into questions to build the tool for an adequate QoL assessment in these patients. The specific aims are: 1) To carry out an evaluation of the existing EORTC QLQ-BR 45 (adapting for male BC) and for suitability of use in male BC patients 2) To carry out an evaluation of the EORTC QLQ-PR25 (adapting for male BC) for suitability of use in male BC patients 3) To provide recommendations to the EORTC on a suitable assessment approach to assess QOL in male BC Statistical methods: A systematic literature review to assess what factors are unique to male BC patients in influencing their QoL and what QoL measures exist for them will be performed. This will be conducted by reviewing all studies with male BC participants and including investigator brochures describing side effects in male BC patients, as well as by evaluating issues captured by other existing EORTC modules. The final list of potential QoL issues relevant to the male BC will be tested for relevance and importance in semi-structured qualitative interviews with patients and HCP. A total of 2-5 patients per year will be recruited from collaborating hospitals/countries. At least 40 in total will be interviewed before, during, or after treatment for male BC. At least 2 experts/country from the all collaborating centres will be included in the interview to discuss and consider the potential issues. Finally, the issue list will be translated into questions to build the tool for a QoL assessment in male BC patients. Present accrual and target accrual This study started in October 2019. A systematic literature review has been completed. Seventeen centres from worldwide are participating in the study. New centers may still join. Contact information for people with a specific interest in the trial Vesna Bjelic-Radisic E-Mail: Vesna.Bjelic-Radisic@helios-gesundheit.de Fatima Cardoso e-mail: fatimacardoso@fundacaochampalimaud.pt Citation Format: Vesna Bjelic-Radisic, Fatima Cardoso, Joachim Weis, Eveline Bleiker, David Cameron, Galina Velikova, Karatzyna Pogoda, Samantha Serpentini, Kevin Punie, Rinat Yerushalmi, Erika Matos, Birgit Carly, Ivana Bozovic-Spasojevic, Markus Fleisch, Zoe Luisa Probst, Sina Maria Schafer, Nicola Russell, Sofie Tombeur, Joanna Vermeij, Heidi Roelstraete, Kathryn Ruddy, Juan I Arraras, Andrew Bottomley. Adaption of the EORTC quality of life breast cancer module for male breast cancer - phase I [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-14-01.

IBD-related Malignancies Observed in 2015–2019 : 4 Years’ Results from the Prospective, Nationwide Hungarian Registry IBD-related Malignancies – Hungarian Registry

Introduction: Patients with inflammatory bowel disease (IBD) have an increased risk to develop malignant neoplasms. Neither the exact mechanism, nor the frequency of different malignancies is completely clear. Our aim was to assess the IBD associated malignancies, to collect clinical and mortality data and to analyse possible risk factors. Methods: Data on malignancies developed between January 2015 and May 2019 in Hungarian IBD patients was recorded. Every member of the Hungarian Society of Gastroenterology was prospectively interviewed. The following data were collected: demographic data, disease characteristics, previous therapy, patient adherence, type and localisation of malignancies. Results: 140 IBD patients with newly diagnosed malignancies were reported. 61.4%, 35.7%, and 2.9% of the patients had ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis, respectively. The mean latency was 15.2±10.5 years. Colorectal cancer (CRC) was the most common cancer (49.6%, 70). 72.9% (51/70) of them was associated with UC, more than 80% had extensive (50.9%, 26) and left-sided (31.2%, 16) colitis. The most frequent CRC localisation was the rectosigmoid colon in UC (54.9%), and the rectum in CD (38.9%). The most common non-CRC malignancies were non-melanotic skin-cancer, haematological and pulmonary cancer. Disease duration at the time of the diagnosis of malignancy was lower (17.9±10.7 versus 12.6±9.7 years); mean age at the time of the death was higher (49.3±9.4 versus 64.3±16.4 years); and survival was longer after the diagnosis of extraintestinal malignancy than CRC (0.73±1.01 versus 1.2±0.8). Summary: CRC presented typically in the distal part of the colon by male UC patients with pancolitis or left-sided colitis with a long-standing disease course of IBD. The most common non-CRC malignancies were non-melanotic skin cancer, haematological cancer and lung cancer. Non-CRC malignancies developed typically in female patients, older than CRC patients with shorter disease-course of IBD and longer survival times.

Long-Term Outcomes in 831 Kidney Transplant Recipients with 20 Years of Graft Function

An understanding of long-term outcomes for kidney transplant(KTx) recipients who survive with graft function beyond a specific time posttransplant is the first step in creating protocols to optimize care for current and improve outcomes for future recipients. We studied 831KTx recipients-580 living donor(LD); 251 deceased donor(DD)—with graft survival(GS) &gt;20 years. For primary LD recipients, 25-year patient survival(PS) was 83%; 35-year, 59%. Their 25-year death-censored graft survival(DCGS) was 89%; 35-year, 72%. DD recipients had lower PS(P&lt;0.01), DCGS(P&lt;0.01). After 20 years, two major causes of graft loss(GL) were death with function(DwF)(58%, LD; 58%, DD) and interstitial fibrosis and tubular atrophy(IFTA)(22%, LD; 23%, DD). Two major causes of DwF were cancer(31%, LD; 31%, DD) and cardiovascular disease(CVD)(19%, LD;17%, DD). Per multivariate analysis(MVA), risk factors for GL after 20 years in pre–calcineurin inhibitor(CNI) era were human leukocyte antigen(HLA) mismatches &gt;3 antigens, pretransplant type 1 diabetes mellitus(DM1); in CNI era, a history of rejection, female gender. New comorbidities after 20 years were common: CVD(13%, non-DM1;18%, DM1), infections(27%, non-DM1;37%, DM1), 20-29 years posttransplant. Cancer after 20 years included: nonmelanotic skin cancer,22%; solid organ,7%; post-transplant lymphoproliferative disease(PTLD),2%. To improve long-term outcomes, clinical trials on prevention, recognition, and treatment of new comorbidities are needed.

Excision margins of 1000 non-melanotic skin cancers – are these influenced by site or reconstruction type?

Excision margins of 1000 non-melanotic skin cancers – are these influenced by site or reconstruction type?

S2965 Melanoma Presenting as Upper Gastrointestinal Bleed: Rare Primary vs Metastasis of Unknown Origin

INTRODUCTION: Melanoma is the most serious form of skin cancer and the fifth most common cancer in the United States. It generally appears where melanocytes are found in abundance including the eyes, skin and anal region. When found in the GI tract, the overwhelming cause is metastatic spread. This manifests as abdominal pain, fatigue, GI bleeds and their sequelae. Primary gastric melanoma is an exceedingly rare entity requiring thorough physical examination and imaging in order to rule out metastatic disease as the cause. We present a case of GI bleed secondary to gastric melanoma in which no other primary lesion was noted. CASE DESCRIPTION/METHODS: A 92-year-old man with a history of non-melanotic skin cancer presented to the emergency department with a 3-day history of melena. He was found to be hemodynamically stable with a mild normocytic anemia. He had never had an EGD and most recent colonoscopy was 15 years prior, notable for only diverticulosis. EGD performed during admission was significant for a large cratered mass in the gastric body identified as the source of bleeding. Biopsies were taken of the mass and returned strongly positive for S-100, Melan-A and Sox-10, consistent with malignant melanoma. Further evaluation with dermatology as well as oncology involved a thorough physical exam with skin check, PET CT as well as MRI brain, none of which revealed any other primary lesion consistent with melanoma. Due to the patient’s age, a decision was made to treat non-surgically. He opted for single-agent immunotherapy with pembrolizumab. PET CT after four cycles showed that the lone site of uptake in the stomach was no longer hypermetabolic. Patient has since finished eight cycles of pembrolizumab. DISCUSSION: This is a case of gastric melanoma in which no primary oculocutaneous source was identified. Given the exceedingly rare incidence of primary gastric melanoma, cases like these raise the question of a regressed primary cutaneous melanoma. This case illustrates that when GI melanoma is identified, a thorough skin exam and PET imaging are warranted to rule out a more common primary source. However, a negative evaluation does not completely eliminate the possibility of metastasis from a more common origin.Figure 1.: Gastric Melanoma Prior to Biopsy.

Epidemiology, mortality and prevalence of colorectal cancer in ulcerative colitis patients between 2010-2016 in Hungary – a population-based study

The incidence and prevalence of ulcerative colitis (UC) varies geographically. The risk of colorectal cancer (CRC) and possibly some other malignancies is increased among patients with UC. It is still debated if patients with UC are at a greater risk of dying compared with the general population. Our aim was to describe the epidemiology and mortality of the Hungarian UC population from 2010 to 2016 and to analyze the associated malignancies with a special focus on CRC. This is an observational, descriptive, epidemiological study based on the National Health Insurance Fund social security databases from 2010 to 2016. All adult patients who had at least two events in outpatient care or at least two medication prescriptions, or at least one inpatient event with UC diagnosis were analyzed. Malignancies and CRC were defined using ICD-10 codes. We also evaluated the survival of patients suffering from UC compared with the general population using a 3 to 1 matched random sample (age, gender, geography) from the full population of Hungary. We found the annual prevalence of UC 0.24-0.34%. The incidence in 2015 was 21.7/100 000 inhabitants. Annual mortality rate was 0.019-0.023%. In this subpopulation, CRC was the most common cancer, followed by non-melanotic skin and prostate cancer. 8.5% of the UC incident subpopulation was diagnosed with CRC. 470 (33%) of the CRC patients died during the course of the study (25% of all deaths were due to CRC), the median survival was 9.6 years. UC patients had significantly worse survival than their matched controls (HR = 1.65, 95% CI: 1.56-1.75). This is the first population-based study from Eastern Europe to estimate the different malignancies and mortality data amongst Hungarian ulcerative colitis patients. Our results revealed a significantly worse survival of patients suffering from UC compared to the general population.

Quality of Life Studies in Skin Cancer Treatment and Reconstruction.

Health-related quality of life (HRQOL) is an important measure of patient experience before, during, and after treatment for skin cancers. Over the past 20 years, a variety of generic as well as disease-specific HRQOL instruments have been developed to assess clinical outcomes. Clinical trials have increasingly focused on using HRQOL instruments as outcome measures. Patients with both cutaneous melanoma and nonmelanotic skin cancers have been found to experience improvement in HRQOL following surgical treatment and reconstruction. Individual demographic variables may further predict experience within each of these groups. Increasing use of HRQOL instruments in future studies comparing skin cancer treatments will allow physicians to better understand and optimize patient experiences.