The French journal of urology · 2024
Prostate cancer in solid organ transplant recipients: Results from a multicenter series.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Hedhli Oussama, Marra Giancarlo, Karam Georges, Glemain Pascal, Chelghaf Ismaël, De Vergie Stéphane, Perrouin Verbe Marie Aimée, Biancone Luigi, Gontero Paolo, Bouchot Olivier, Rigaud Jérôme, Branchereau Julien
Аннотация
INTRODUCTION: Prostate cancer incidence in immunosuppressed transplant recipients increases as life expectancy improves in this population. However, the management of treatments and immunosuppressive (IS) regimens for solid organ transplant recipients diagnosed with prostate cancer remains poorly defined. Therefore, we conducted a multicentric study to investigate these parameters more thoroughly.
METHOD: This multicentric, retrospective study includes all kidney, heart, liver, or combined transplant recipients, diagnosed with prostate cancer between 1998 and 2020. IS regimen management, demographic, oncological and survival outcomes were studied here.
RESULTS: A prostate cancer was diagnosed among 87 SOTRs: 70 RTRs, 10 HTRs, 2 LTRs and 5 combined transplant recipients. The mean age at diagnosis was 64.3years with 10.7years mean time from transplantation to PCa. A 38% low risk, 45% intermediate risk and 11% high risk were recorded at diagnosis. Fifty-six patients underwent radical prostatectomy, 11 patients underwent radiotherapy combined with ADT, 4 patients underwent radiotherapy alone, 6 patients underwent ADT alone, 1 patient underwent brachytherapy, 3 patients underwent watchful waiting, 1 patient was treated by HIFU and 5 patients were under active surveillance. Sixteen patients had complementary treatment following biochemical recurrence or positive margins. IS regimen was modified for 69% of patients. Twelve deaths occurred in total (14%) with a 92% and 86%, 3- and 5-year overall survival respectively. Three- and 5-year progression-free survival were 89% and 83% respectively. There was no significant PFS difference between patients treated with radiotherapy and prostatectomy (P=0.94), and patients with or without a change in immunosuppressants (P=0.88).
CONCLUSION: Guidelines for diagnosis and management of prostate cancer in the general population appears to apply in SOTRs with good oncological outcomes. Active surveillance should also be considered in this population.
LEVEL OF EVIDENCE: Low.
METHOD: This multicentric, retrospective study includes all kidney, heart, liver, or combined transplant recipients, diagnosed with prostate cancer between 1998 and 2020. IS regimen management, demographic, oncological and survival outcomes were studied here.
RESULTS: A prostate cancer was diagnosed among 87 SOTRs: 70 RTRs, 10 HTRs, 2 LTRs and 5 combined transplant recipients. The mean age at diagnosis was 64.3years with 10.7years mean time from transplantation to PCa. A 38% low risk, 45% intermediate risk and 11% high risk were recorded at diagnosis. Fifty-six patients underwent radical prostatectomy, 11 patients underwent radiotherapy combined with ADT, 4 patients underwent radiotherapy alone, 6 patients underwent ADT alone, 1 patient underwent brachytherapy, 3 patients underwent watchful waiting, 1 patient was treated by HIFU and 5 patients were under active surveillance. Sixteen patients had complementary treatment following biochemical recurrence or positive margins. IS regimen was modified for 69% of patients. Twelve deaths occurred in total (14%) with a 92% and 86%, 3- and 5-year overall survival respectively. Three- and 5-year progression-free survival were 89% and 83% respectively. There was no significant PFS difference between patients treated with radiotherapy and prostatectomy (P=0.94), and patients with or without a change in immunosuppressants (P=0.88).
CONCLUSION: Guidelines for diagnosis and management of prostate cancer in the general population appears to apply in SOTRs with good oncological outcomes. Active surveillance should also be considered in this population.
LEVEL OF EVIDENCE: Low.