Elsevier

Urology

Volume 52, Issue 3, September 1998, Pages 428-432
Urology

Adult Urology
Prostate cancer in the post-transplant population

https://doi.org/10.1016/S0090-4295(98)00211-8Get rights and content

Abstract

Objectives. We conducted a multicenter retrospective study to determine the results of treatment for prostate cancer in solid organ transplant recipients.

Methods. A retrospective analysis of all patients diagnosed with prostate cancer after organ transplantation at five centers was conducted. Data were obtained by chart review and a multipoint data sheet was used to abstract the data from the patient charts.

Results. Eighteen cases of prostate cancer were identified from six institutions. Most (84%) of the cancers were clinically localized at the time of diagnosis. Nine (50%) of 18 patients underwent radical prostatectomy, which was the predominant mode of treatment. Overall survival at a mean follow-up of 32 months was 66%, with a cancer specific mortality of 16%. Mortality was 13% for the 15 patients with localized disease and 33% for the 3 patients with metastatic disease at the time of diagnosis.

Conclusions. Most of the patients with prostate cancer being detected after solid organ transplantation were diagnosed with localized disease. Aggressive therapeutic intervention as in the general (nontransplant) population yields good results and should be pursued. Diligent surveillance for prostate cancer in this population using periodic digital rectal examination, serum prostate-specific antigen, and prostate needle biopsy as needed will ensure earlier cancer detection and allow for definitive therapeutic intervention.

Section snippets

Material and methods

Between January 1991 and December 1995, 2446 patients underwent solid organ transplantation at the University of Pittsburgh Medical Center. We examined the computerized case records of these patients to identify those with prostate cancer diagnosed after organ transplantation. All patients with a diagnosis of prostate cancer before transplantation or between one failed transplant and the next were eliminated. Only patients who first received the diagnosis of the disease after transplantation

Results

Of the 18 patients, 16 had undergone cadaveric renal transplantation, and 1 each had undergone liver and heart transplantation. Mean patient age was 62 years (range 47 to 70). Only one of the kidney transplant recipients underwent retransplantation. In the patients who had undergone kidney transplantation, the etiology of end-stage renal disease included hypertension in 5, diabetes mellitus in 2, obstructive uropathy in 1, glomerulonephritis in 2, and was undetermined in 6. Maintenance

Comment

To our knowledge, this is the largest reported series of patients with prostate cancer diagnosed after organ transplantation. Previously published data describe series of 3 or fewer patients.6, 7, 8, 9 These reports describe successful outcome after radical prostatectomy, but the small numbers involved do not permit any meaningful analysis of incidence and outcome in these patients. Moreover, follow-up information is scant for most of these cases.

Data from the National Cancer Data Base for

Conclusions

The incidence of prostate cancer in the post-transplant population has probably been underestimated because most transplant centers have only recently begun routine periodic screening for this disease with PSA and DRE. Prostate cancer is receiving an unprecedented degree of attention in the general male population and justifiably so because it has become the most common male cancer. Therefore, we thought it important to examine the incidence and treatment of prostate cancer in the male

References (13)

There are more references available in the full text version of this article.

Cited by (49)

  • The role of radiotherapy in patients with solid tumours after solid organ transplantation: a systematic review

    2021, The Lancet Oncology
    Citation Excerpt :

    The reported 1-year overall survival rates ranged from 74% to 100%.27,29,32 We identified 26 publications reporting data on 149 kidney transplant recipients who received radiotherapy (tables 1–3).25,26,41–59 The median interval between transplantation and radiotherapy was 58·5 months (range 6·0–168·0).

  • Morbidity, perioperative outcomes and complications of robot-assisted radical prostatectomy in kidney transplant patients: A French multicentre study

    2020, Urologic Oncology: Seminars and Original Investigations
    Citation Excerpt :

    Cancer development has become a major problem in KTRs and is currently one of the primary causes of death in this population [4]. Genitourinary malignancies stand for 34% of the nonskin solid cancer in KTR [5]. Prostate cancer (PCa) incidence remains controversial some studies reported a 2 to 5 times higher incidence in KTR [6,7] but other showed a similar or lower incidence than in the general population [2,8].

View all citing articles on Scopus
View full text