Prostate cancer characteristics and outcome in renal transplant recipients: results from a contemporary single center study

Pettenati, C.; Jannot, Anne‐Sophie; Hurel, S.; Verkarre, Virginie; Kreis, Henri; Housset, M.; Legendre, Christophe; Méjean, Arnaud; Timsit, Marc‐Olivier

doi:10.1111/ctr.12773

Cited by 30 publications

(38 citation statements)

References 63 publications

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“…We included 27 studies reporting oncological and/or functional outcomes of PCa treatment in RTRs for a total of 241 patients from 25 cohort studies and nine case reports (Table ). Studies were published between 1991 and 2016 , including patients treated from 1968 . Generally, the quality of the included records was low, with no prospective dataset.…”

Section: Methodsmentioning

confidence: 99%

“…Five groups reported the use of PCa screening in RTRs usually performing annual PSA measurement and DRE in all men aged 40–50 years and not stating any upper age limit. The PSA threshold for undergoing biopsy was not consistent, with one series using a PSA >2.5 ng/mL instead of 4 ng/mL .…”

Section: Methodsmentioning

confidence: 99%

“…The open retropubic approach was more frequent (radical retropubic prostatectomy [RRP], n = 108), followed by robot‐assisted RP (RARP, n = 32), open perineal RP (radical perineal prostatectomy [RPP], n = 15) and laparoscopic RP (LRP, n = 15). In 16 patients, the RP technique used was not stated . Criteria for preoperative staging were rarely stated (five studies).…”

Section: Methodsmentioning

confidence: 99%

“…Of five deaths, four were PCa‐ and/or graft‐unrelated while one patient had persistently elevated postoperative PSA levels, with metastases 5 months later. This patient received ADT and developed castration‐resistant PCa, dying 76.7 months after RP . The impact of LND on BCR, CSS and OS was never assessed.…”

Section: Methodsmentioning

confidence: 99%

“…^Number available for CSS, OS, BCR data (does not necessarily correspond to all treated patients). *All surgical procedures, also including 16 patients from Pettenati et al , where radical prostatectomy (RP) technique is not specified. **Includes 16 patients from Pettenati et al , where RP technique is not specified.…”

Section: Methodsmentioning

confidence: 99%

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Prostate cancer treatment in renal transplant recipients: a systematic review

et al. 2017

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The aim of this review was to summarize the current evidence and to highlight the main issues future research needs to address regarding prostate cancer (PCa) treatment in renal transpant recipients (RTRs). We conducted a search of AMED, Medline and Embase up to 17 November 2016 to investigate oncological and functional outcomes of PCa treatment in RTR. Type and use/protocols of immunosuppression and peri-operative antibiotic drugs were also assessed. The search was implemented manually. Exclusion criteria were absence of full text or absence of information that allowed us to differentiate oncological and/or functional outcomes of each therapeutic approach used. We included 241 patients from 27 retrospective studies published between 1991 and 2016; seven of the studies were case-control and 20 were case series. We also considered nine case reports published between 1999 and 2016. Follow-up ranged from 1 to 120 months. PCa was organ-confined, with Gleason score ≤6 in 75.2% and 60.4% of patients. Surgery was the most frequent treatment used (n = 186), for which cancer-specific (CSS) and overall survival (OS) rates were both 96.8%. Functional outcomes, including continence and erectile function, and complications were less frequently reported and were generally similar to those reported for radical prostatectomy (RP) in non-RTRs. Other treatment methods in the patients included in the review were radiotherapy (RT) ± androgen deprivation therapy (ADT; n = 34; OS 88.2%; CSS 88.2%), ADT alone (n = 14; OS 42.9%; CSS 64.3%), brachytherapy (BT; n = 11; OS and CSS 100%), watchful waiting (n = 4) and active surveillance (n = 1). Overall no treatment-related graft loss occurred. Immunosuppression and antibiotic schemes were poorly reported and inconsistent. Outcomes of PCa treatment in RTRs are encouraging and do not appear to be inferior to those of non-RTR. RP was the most commonly assessed approach, whilst RT, BT and ADT were less frequent. Immunosuppression and antibiotic use were poorly reported and highly variable. High-quality studies are needed because the current level of evidence is low, and our results should therefore be interpreted with caution.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prostate cancer treatment in renal transplant recipients: a systematic review

et al. 2017

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The role of localised prostate cancer treatment in renal transplant patients: A systematic review

et al. 2023

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ObjectiveTo systematically review and critically appraise all treatment options for localised prostate cancer in renal transplant candidates and recipients.MethodA systematic review was conducted adhering to PRISMA guidelines. Searches were performed in the Cochrane Library, Embase, Medline, the Transplant Library and Trip database for studies published up to September 2022. Risk of bias was assessed with the Cochrane Risk of Bias in Non‐Randomised Studies of Interventions for non‐randomised studies tool.ResultsA total of 60 studies were identified describing 525 patients. The majority of studies were either retrospective non‐randomised comparative or case series/reports of poor quality. The vast majority of studies were focussed on prostate cancer after renal transplantation. Overall, 410 (78%) patients underwent surgery, 93 (18%) patients underwent radiation therapy or brachytherapy, one patient underwent focal therapy (high‐intensity frequency ultrasound) and 21 patients were placed on active surveillance. The mean age was 61 years old, the mean PSA level at diagnosis was 9.6 ng/mL and the mean follow‐up time was 31 months. The majority of patients had low‐risk disease with 261 patients having Gleason 6 prostate cancer (50%), followed by 220 Gleason 7 patients (42%). All prostate cancer mortality cases were in high‐risk prostate cancer (≥Gleason 8). The cancer‐specific survival results were similar between surgery and radiotherapy at 1 and 3 years.ConclusionLocalised prostate cancer treatment in renal transplant patients should be risk stratified. Surgery and radiation treatment for localised prostate cancer in renal transplant patients appear equally efficacious. Given the limitations of this study, future research should concentrate on developing a multicentre RCT with long‐term registry follow‐up.

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Over-diagnosed prostate cancer in solid organ recipients: lessons from the last 3 decades

Waeckel

Said

Altieri³

et al. 2020

Int Urol Nephrol

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Prostate cancer characteristics and outcome in renal transplant recipients: results from a contemporary single center study

Abstract: Localized PCa following renal transplantation was not associated with adverse features as compared with non-transplant patients. Standard treatments could be proposed to RTR with satisfying results both on oncological outcome and graft function.

Cited by 30 publications

References 63 publications

Prostate cancer treatment in renal transplant recipients: a systematic review

Prostate cancer treatment in renal transplant recipients: a systematic review

The role of localised prostate cancer treatment in renal transplant patients: A systematic review

Over-diagnosed prostate cancer in solid organ recipients: lessons from the last 3 decades

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