2075 PROSTATE CANCER IN RENAL TRANSPLANT RECIPIENTS: BIOPSY COMPLICATIONS AND ONCOLOGIC CHARACTERISTICS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery I1 Apr 20102075 PROSTATE CANCER IN RENAL TRANSPLANT RECIPIENTS: BIOPSY COMPLICATIONS AND ONCOLOGIC CHARACTERISTICS Sergey S. Ananyev, Rizk El-Galley, and J. Erik Busby Sergey S. AnanyevSergey S. Ananyev More articles by this author , Rizk El-GalleyRizk El-Galley More articles by this author , and J. Erik BusbyJ. Erik Busby More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2135AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are presently no established guidelines for prostate cancer (CaP) screening, detection, and treatment in male renal transplant recipients (RTR). Outcomes for RTR with CaP are varied when compared to non-RTR. Only one previous study has examined the morbidity of biopsy in RTR undergoing evaluation for CaP. We compared a large population of RTR to a non-RTR cohort at a single institution to determine the rate of periprocedural infections from prostate biopsy and subsequent CaP characteristics and outcomes METHODS Of 2,478 RTR from 1993 to 2007, 29 underwent prostate biopsy. Infectious complication was defined as 3 of 4 criteria (T>101F, WBC > 12,000, positive urine culture, positive blood culture), or any criteria coupled with hospitalization. The RTR cohort was compared to 2053 non-RTR men who underwent biopsy in the same period (random sampling of 145 men out of 2053 performed for accurate statistical analysis). Cancer characteristics, treatment, and oncologic outcomes were also compared between the subset of each cohort diagnosed with CaP. RESULTS Of RTR and non-RTR respectively, infectious complication occurred in 10% and 0.7% (p=0.016), and of patients biopsied, CaP was detected in 64% and 46% (p=0.079). Comparing RTR and non-RTR cohorts respectively, mean total Gleason grades were 6.11 and 6.48 (p=0.09), mean primary Gleason grades were 3.06 and 3.18 (p=0.343) and secondary Gleason grades were 3.0 and 3.31 (p=0.042). Treatment for RTR vs non-RTR respectively included active surveillance in 21% and 10%, radiation in 42% and 48%, prostatectomy 32% and 38%, and hormonal ablation 5% and 5%. No difference was seen in the treatment between cohorts (p=0.584). D'Amico risk criteria were low (in 47% versus 48%), intermediate (in 42% versus 36%), and high (in 11% versus 16%) with overall comparable risk distribution (p=0.812) in RTR vs non-RTR. Within African American RTR, there was increased intermediate risk CaP (p=0.003), but otherwise there were no differences among groups. Immunosuppressants did not impact cancer characteristics. CONCLUSIONS Although there is a trend towards increased detection in RTR, the groups have similar CaP risk categories. RTR present with higher secondary Gleason scores and African American RTR have increased intermediate risk CaP. RTR have a significantly increased risk for infectious complications after prostate biopsy, warranting improved measures and patient education. Birmingham, AL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e807 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sergey S. Ananyev More articles by this author Rizk El-Galley More articles by this author J. Erik Busby More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...