Prostate Cancer in Renal Transplant Recipients : Results from a Large Contemporary Cohort
Marra, Giancarlo (Hôpital Tenon)
Soria, Francesco (University of Turin and Città della Salute e della Scienza)
Peretti, Federica (University of Turin and Città della Salute e della Scienza)
Oderda, Marco (University of Turin and Città della Salute e della Scienza)
Dariane, Charles (Hôpital Européen Georges Pompidou (París, França))
Timsit, Marc-Olivier (Hôpital Européen Georges Pompidou (París, França))
Branchereau, Julien (Oxford University)
Hedli, Oussama (Institut de Transplantation Urologie Nèphrologie (ITUN))
Mesnard, Benoit (Institut de Transplantation Urologie Nèphrologie (ITUN))
Tilki, Derya (University Hospital Hamburg-Eppendorf)
Olsburgh, Jonathon (Guy's and St Thomas' NHS Foundation Trust (Regne Unit))
Kulkarni, Meghana (Guy's and St Thomas' NHS Foundation Trust (Regne Unit))
Kasivisvanathan, Veeru (University College London)
Lebacle, Cedric (Kremlin-Bicêtre Hospital)
Rodriguez-Faba, Oscar (Fundacio Puigvert)
Breda, Alberto (Institut d'Investigació Biomèdica Sant Pau)
Soeterik, Timo (Saint Antonius Hospital)
Gandaglia, Giorgio (IRCCS Ospedale San Raffaele (Milà, Itàlia))
Todeschini, Paola (Sant'Orsola Malpighi Hospital)
Biancone, Luigi (University of Turin and Città della Salute e della Scienza)
Gontero, Paolo (University of Turin and Città della Salute e della Scienza)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	The aim of this study was to assess the natural history of prostate cancer (PCa) in renal transplant recipients (RTRs) and to clarify the controversy over whether RTRs have a higher risk of PCa and poorer outcomes than non-RTRs, due to factors such as immunosuppression. We performed a retrospective multicenter study of RTRs diagnosed with cM0 PCa between 2001 and 2019. Primary outcomes were overall (OS) and cancer-specific survival (CSS). Secondary outcomes included biochemical recurrence and/or progression after active surveillance (AS) and evaluation of variables possibly influencing PCa aggressiveness and outcomes. Management modalities included surgery, radiation, cryotherapy, HIFU, AS, and watchful waiting. We included 166 men from nine institutions. Median age and eGFR at diagnosis were 67 (IQR 60-73) and 45. 9 mL/min (IQR 31. 5-63. 4). ASA score was >2 in 58. 4% of cases. Median time from transplant to PCa diagnosis was 117 months (IQR 48-191. 5), and median PSA at diagnosis was 6. 5 ng/mL (IQR 5. 02-10). The biopsy Gleason score was ≥8 in 12. 8%; 11. 6% and 6. 1% patients had suspicion of ≥cT3 > cT2 and cN+ disease. The most frequent management method was radical prostatectomy (65. 6%), followed by radiation therapy (16. 9%) and AS (10. 2%). At a median follow-up of 60. 5 months (IQR 31-106) 22. 9% of men (n = 38) died, with only n = 4 (2. 4%) deaths due to PCa. Local and systemic progression rates were 4. 2% and 3. 0%. On univariable analysis, no major influence of immunosuppression type was noted, with the exception of a protective effect of antiproliferative agents (HR 0. 39, 95% CI 0. 16-0. 97, p = 0. 04) associated with a decreased risk of biochemical recurrence (BCR) or progression after AS. PCa diagnosed in RTRs is mainly of low to intermediate risk and organ-confined at diagnosis, with good cancer control and low PCa death at intermediate follow-up. RTRs have a non-negligible risk of death from causes other than PCa. Aggressive upfront management of the majority of RTRs with PCa may, therefore, be avoided.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Immunosuppression ; Prostate cancer ; Renal transplant ; Robotic radical prostatectomy ; Treatment
Publicat a:	Cancers, Vol. 15 Núm. 1 (january 2023) , p. 189, ISSN 2072-6694

DOI: 10.3390/cancers15010189
PMID: 36612184

10 p, 267.6 KB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Articles > Articles de recerca
Articles > Articles publicats