Is Localized Prostate Cancer an Obstacle for an Immediate Consideration for Renal Transplantation? A Case Report

doi:10.1016/j.transproceed.2009.01.111

Transplantation Proceedings

Volume 41, Issue 5, June 2009, Pages 1961-1962

https://doi.org/10.1016/j.transproceed.2009.01.111 Get rights and content

Abstract

Currently, renal failure patients with a history of prostate cancer are recommended to have a 2 to 5-year disease-free interval prior to being allowed to receive a kidney transplant. This disease is now amenable to curative therapy if diagnosed at an early stage when the tumor is organ-confined. We report a patient undergoing immediate renal transplantation following a laparoscopic radical prostatectomy for the treatment of prostate cancer. Candidates for renal transplantation who are diagnosed with early stage, organ-confined prostate cancer may be immediately considered for transplantation following radical prostatectomy in view of the high likelihood of cure of their prostate cancer.

Section snippets

Case Report

A 57-year-old man with CRF caused by adult polycystic kidney disease was evaluated for living related kidney transplantation from his wife. His renal transplantation evaluation was unremarkable except for a serum PSA level of 3.2 ng/mL, which was high for his age. Transrectal ultrasound-guided prostate biopsy revealed 1 of 10 cores to be positive for cancer at the left far lateral midgland (Gleason 3 + 3 = 6, constituting 80% of the core). Based on the tables of Partin et al, his predicted

Discussion

Renal transplantation in potential recipients with prostate cancer is a controversial issue. Penn suggested a waiting period of approximately 5 years before a kidney transplant for most patients with prostate cancer, for he observed an 18% prostate cancer recurrence rate among 33 kidney transplant patients, most of whom were treated between 2 and 5 years before their transplant.¹ Most patients had advanced prostate cancer, like stage T3 disease. Most patients had been diagnosed and treated

References (10)

E.S. Woodle et al.
Prostate cancer prior to solid organ transplantation: the Israel Penn International Transplant Tumor Registry experience
Transplant Proc
(2005)
M. Whang et al.
Renal transplantation and prostate cancer: guidelines for screening and treatment
Transplant Proc
(2002)
I. Penn
Evaluation of transplant candidates with pre-existing malignancies
Ann Transplant
(1997)
A.W. Partin et al.
Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancerA multi-institutional update
JAMA
(1997)
M.W. Kattan et al.
A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer
J Natl Cancer Inst
(1998)

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

Cited by (5)

Localized Prostate cancer in candidates for renal transplantation and recipients of a kidney transplant: The French Guidelines from CTAFU
2021, Progres en Urologie
Le but du Comité de transplantation de l’Association française d’urologie est de proposer des recommandations pour la prise en charge du cancer de la prostate localisé (CaP) chez le candidat ou le receveur d’un transplant rénal.
Une revue de la littérature d’approche systématique (Medline) a été conduite par le CTAFU concernant l’épidémiologie, le dépistage, le diagnostic et le traitement du CaP chez le candidat ou le receveur d’un transplant rénal en évaluant les références et leurs niveaux de preuve.
L’incidence du CaP chez le transplanté rénal est similaire à la population générale. Le dépistage dans cette population doit suivre les recommandations du CCAFU. Le dépistage est systématique chez le candidat à un transplant rénal de plus de 50 ans. Le diagnostic repose sur les biopsies de la prostate réalisées après IRM multiparamétrique et sans spécificité de l’antibioprophylaxie. Les recommandations thérapeutiques du CaP proposées par le CCAFU restent applicables à la population des patients transplantés avec certaines spécificités en particulier pour le traitement des aires ganglionnaires. Pour les candidats à la transplantation rénale, la problématique de l’accès à la transplantation doit être prise en compte. Les données actuelles permettent de proposer des délais de carence après traitement du CaP avec un faible niveau de preuve.
Ces recommandations françaises doivent contribuer à améliorer la prise en charge du CaP chez le patient candidat ou receveur d’un transplant rénal en intégrant objectifs oncologiques et accès à la transplantation.
To define guidelines for the management of localized prostate cancer (PCa) in kidney transplant (KTx) candidates and recipients.
A systematic review (Medline) of the literature was conducted by the CTAFU to report prostate cancer epidemiology, screening, diagnosis and management in KTx candidates and recipients with the corresponding level of evidence.
KTx recipients are at similar risk for PCa as general population. Thus, PCa screening in this setting is defined according to global French guidelines from CCAFU. Systematic screening is proposed in candidates for renal transplant over 50 y-o. PCa diagnosis is based on prostate biopsies performed after multiparametric MRI and preventive antibiotics. CCAFU guidelines remain applicable for PCa treatment in KTx recipients with some specificities, especially regarding lymph nodes management. Treatment options in candidates for KTx need to integrate waiting time and access to transplantation. Current data allows the CTAFU to propose mandatory waiting times after PCa treatment in KTx candidates with a weak level of evidence.
These French recommendations should contribute to improve PCa management in KTx recipients and candidates, integrating oncological objectives with access to transplantation.
The Risk of Tumour Recurrence in Patients Undergoing Renal Transplantation for End-stage Renal Disease after Previous Treatment for a Urological Cancer: A Systematic Review [Figure presented]
2018, European Urology
Renal transplantation is the gold standard renal replacement therapy in end-stage renal disease owing to its superior survival and quality of life compared with dialysis. When the potential recipient has a history of cancer, the waiting period before renal transplantation is usually based on the Cincinnati Registry.
To systematically review all available evidence on the risk of cancer recurrence in end-stage renal disease patients with a history of urological cancer.
Medline, Embase, and the Cochrane Library were searched up to March 2017 for all relevant publications reporting oncologic outcomes of urological cancer in patients who subsequently received a transplantation or remained on dialysis. The primary outcome was time to tumour recurrence. Secondary outcomes included cancer-specific and overall survival. Data were narratively synthesised in light of methodological and clinical heterogeneity. The risk of bias of each included study was assessed.
Thirty-two retrospective studies enrolling 2519 patients (1733 dialysed, 786 renal transplantation) were included. For renal cell carcinomas, the risks of recurrence, cancer-specific, and overall survival were similar between transplantation and dialysis. For prostate cancer, most of the tumours had favourable prognoses consistent with nomograms. Studies dealing with urothelial carcinomas (UCs) mainly included upper urinary tract UC in the context of aristolochic acid nephropathy, for which the risks of synchronous bilateral tumour and recurrence were high. Data on testicular cancer were scarce.
Immunosuppression after renal transplantation does not affect the outcomes and natural history of low-risk renal cell carcinomas and prostate cancer. Therefore, the waiting time from successful treatment for these cancers to transplantation could be reduced. Except in the particular situation of aristolochic acid nephropathy, more studies are needed to standardise the waiting period after UC owing to the paucity of data.
Renal transplantation does not appear to increase the risk of recurrence of renal carcinoma or the recurrence of low-risk prostate cancer compared with dialysis. More reliable evidence is required to recommend a standard waiting period especially for urothelial and testicular carcinomas.
Kidney transplantation in prostate cancer patients after local therapy with curative intent: a systematic review
2024, World Journal of Urology
The role of localised prostate cancer treatment in renal transplant patients: A systematic review
2023, BJUI Compass
Delaying renal transplant after radical prostatectomy for low-risk prostate cancer
2015, Experimental and Clinical Transplantation

View full text

Case reportKidneyIs Localized Prostate Cancer an Obstacle for an Immediate Consideration for Renal Transplantation? A Case Report

Abstract

Section snippets

Case Report

Discussion

Transplant Proc

Transplant Proc

Evaluation of transplant candidates with pre-existing malignancies

Ann Transplant

Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancerA multi-institutional update

JAMA

A preoperative nomogram for disease recurrence following radical prostatectomy for prostate cancer

J Natl Cancer Inst

Case report
Kidney
Is Localized Prostate Cancer an Obstacle for an Immediate Consideration for Renal Transplantation? A Case Report