Prostate Cancer Screening and Treatment in the Transplant Population: Current Status and Recommendations

Breyer, Benjamin N.; Whitson, Jared M.; Freise, Christopher E.; Meng, Maxwell V.

doi:10.1016/j.juro.2009.01.021

Cited by 33 publications

(34 citation statements)

References 45 publications

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“…In the most recent study of cancer incidence in solid organ transplanted recipients conducted by the National Institute of Health, PC cumulative incidence was approximately 1% in LTRs during an 8-year period [15]. In a review, authors found that the incidence of PC in LTR ranged from 0% to 0.3% of recipients per year [16]. Our incidence was not different from those in the literature.…”

Section: Discussioncontrasting

confidence: 45%

Prostate carcinoma in liver transplant recipients: Think about it!

Tillou

Chiche

Guleryuz

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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Section: Discussioncontrasting

confidence: 45%

Prostate carcinoma in liver transplant recipients: Think about it!

Tillou

Chiche

Guleryuz

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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“…In the transplant population, PSA screening is more complex because of evidence suggesting that PC is more aggressive in renal transplant recipients. 13,20,25,26 Nevertheless, our data demonstrate that PSA screening does not affect post-transplant patient survival (Figure 2). At most, PSA screening is associated with an improvement in graft survival in deceased-donor transplant recipients ,55 years of age ( Figure 3).…”

Section: Discussionmentioning

confidence: 65%

“…20 To the best of our knowledge, the data presented here are the first to associate PSA screening in renal transplant candidates with longer transplant waiting times and reduced transplant probability. Currently, there are no evidence-based recommendations for PC screening in the pre-or post-transplant patient populations.…”

Section: Discussionmentioning

confidence: 77%

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Utility of Prostate Cancer Screening in Kidney Transplant Candidates

Vitiello

Sayed²,

Wardenburg

et al. 2015

JASN

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Screening recommendations for prostate cancer remain controversial, and no specific guidelines exist for screening in renal transplant candidates. To examine whether the use of prostate-specific antigen (PSA)-based screening in patients with ESRD affects time to transplantation and transplant outcomes, we retrospectively analyzed 3782 male patients $18 years of age undergoing primary renal transplant evaluation during a 10-year period. Patients were grouped by age per American Urological Association screening guidelines: group 1, patients ,55 years; group 2, patients 55-69 years; and group 3, patients .69 years. A positive screening test result was defined as a PSA level .4 ng/ml. We used univariate analysis and Cox proportional hazards models to identify the independent effect of screening on transplant waiting times, patient survival, and graft survival. Screening was performed in 63.6% of candidates, and 1198 candidates (31.7%) received kidney transplants. PSA screening was not associated with improved patient survival after transplantation (P=0.24). However, it did increase the time to listing and transplantation for candidates in groups 1 and 2 who had a positive screening result (P,0.05). Furthermore, compared with candidates who were not screened, PSA-screened candidates had a reduced likelihood of receiving a transplant regardless of the screening outcome (P,0.001). These data strongly suggest that PSA screening for prostate cancer may be more harmful than protective in renal transplant candidates because it does not appear to confer a survival benefit to these candidates and may delay listing and decrease transplantation rates.

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“…However, the specific effect of immunosuppressive drugs on prostate cancer is still unknown, with a lack of robust evidence suggesting any deleterious effect on cancer progression [8][9][10][11]. Considering all these information, the natural history of prostate cancer under immunosuppressive drugs and in SOT is controversial.…”

Section: Discussionmentioning

confidence: 99%