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http://dx.doi.org/10.7314/APJCP.2012.13.9.4335

Sirolimus and Non-melanoma Skin Cancer Prevention after Kidney Transplantation: A Meta-analysis  

Gu, Yu-Hong (Department of Pharmaceutics, the Third Affiliated Hospital of Harbin Medical University)
Du, Jia-Xin (Department of Pharmaceutics, the Third Affiliated Hospital of Harbin Medical University)
Ma, Man-Ling (Department of Pharmaceutics, the Third Affiliated Hospital of Harbin Medical University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.9, 2012 , pp. 4335-4339 More about this Journal
Abstract
Background: Whether sirolimus is useful in the prevention of non-melanoma skin cancer (NMSC) remains unclear and we therefore performed this meta-analysis of randomized controlled trials to test the hypothesis that Sirolimus-based immunosuppression is associated with a decrease in NMSC. Methods: The main outcomes were NMSC, squamous-cell carcinoma and basal-cell carcinoma. The pooled risk ratio (RR) with its 95% confidence interval (95%CI) were used to assess the effects. Results: 5 randomized trials involving a total of 1499 patients receiving kidney transplantation were included. Patients undergoing Sirolimus-based immunosuppression had much lower risk of NMSC (RR = 0.49, 95%CI 0.32-0.76, P = 0.001). Subgroup analyses by tumor type showed that Sirolimus-based immunosuppression significantly decreased risk of both squamous-cell carcinoma (RR = 0.58, 95%CI 0.43-0.78, P < 0.001) and basal-cell carcinoma (RR = 0.56, 95%CI 0.37-0.85, P = 0.006). The quality of evidence was high for NMSC, and moderate for squamous-cell carcinoma and basal-cell carcinoma. No evidence of publication bias was observed. Conclusion: High quality evidence suggests that Sirolimus-based immunosuppression decreases risk of non-melanoma skin cancer, and Sirolimus has an antitumoral effect among kidney-transplant recipients.
Keywords
Sirolimus; non-melanoma skin cancer; kidney transplantation; meta-analysis;
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