Our experience in the management of prostate cancer in renal transplant recipients

Abstract

Introduction and objectivesThe management of prostate cancer (PCa) in renal transplant recipients (RTRs) is challenging and remain controversial. Currently there is no consensus about this condition. The aim of the study was to analyze our experience in the diagnosis and management of PCa in RTR. MethodRetrospective monocentric study of a prospective and consecutive database from 2003 to 2017. Inclusion of RTR diagnosed of PCa. Staging and treatment in agreement with the contemporary guidelines. The main outcome measures included clinical staging, type of treatment, oncological outcomes and follow-up. Results1330 renal transplants were performed (787 males), diagnosed of PCa in 33 RTR (4.2%), mean age 66 years±6.3 (51–78). Median PSA was 8.8ng/ml and PSA ratio 0.19. Mean time between renal transplantation and PCa diagnosis 130 months±90 (2–236). Treatments: radical prostatectomy (RP) (n=22; 66.7%), radiation therapy (RT) with androgen deprivation therapy (ADT) (n=7; 21.2%), active surveillance (n=3; 9.1%), and ADT (n=1; 3%). No graft loss neither impaired renal function due to PCa treatment was reported. After RP two patients (9.1%) presented biochemical recurrence treated with RT. Remission of the 100%. Mean follow-up was 61 months±37 (6–132). ConclusionsPCa in renal transplant patients can be managed with the same therapeutic options as in the general population. Active surveillance should also be provided in RTR despite being under immunosuppressive therapy.