Prostate cancer before renal transplantation: A multicentre study

Prog Urol. 2017 Mar;27(3):166-175. doi: 10.1016/j.purol.2017.01.001. Epub 2017 Feb 23.

Abstract

Introduction: The surgical issues of renal transplantation (RT) after localized prostate cancer (PC) treatment and oncological outcomes after transplantation in patients on the waiting list with a history of PC were unknown. We conducted a retrospective multicentre study including all patients with PC diagnosed before the kidney transplantation.

Methods: Fifty-two patients were included from December 1993 to December 2015. The median age at diagnosis of PC was 59.8years old.

Results: The median PSA rate at diagnosis was 7ng/mL. Twenty-seven, Twenty-four, and one PC were respectively low, intermediate and high risk according to d'Amico classification. Forty-three patients were treated by radical prostatectomy (RP): 28 retropubic, 15 laparoscopic and 3 by a perineal approach. Eighteen patients had a lymph node dissection. Four patients were treated with external radiotherapy and 2 by brachytherapy. Eight patients underwent radiotherapy after surgery. The median time between PC treatment and RT was 35.7 months. The median operating time for the renal transplantation was 180min (IQR 150-190; min 90-max 310) with a median intraoperative bleeding of 200mL (IQR 100-290; min 50-max 2000). A history of lymphadenectomy did not significantly lengthen operative time (P=0.34). No recurrence of PC was observed after a median follow of 36months.

Conclusion: PC discovered before RT should be treated with RP to assess the risk of recurrence and decrease waiting for a RT. If the PC is at low risk of recurrence, it seems possible to shorten the waiting time before the RT after a multidisciplinary discussion meeting.

Level of evidence: 4.

Keywords: Cancer de prostate; Kidney transplantation; Prostatic neoplasms; Transplantation rénale.

Publication types

  • Multicenter Study

MeSH terms

  • Blood Loss, Surgical
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Operative Time
  • Prostate-Specific Antigen / blood
  • Prostatectomy
  • Prostatic Neoplasms / therapy*
  • Radiotherapy, Adjuvant
  • Retrospective Studies

Substances

  • Prostate-Specific Antigen