Presentation Authors: Usman M Haroon*, Niall F Davis, D M Little, Gordan Smyth, P Mohan, James C Forde, Richard E Power, Dublin, Ireland
Introduction: To review the incidence, management and survival outcomes of prostate cancer (PCa) among kidney transplant recipients (KTRs) and to compare these characteristics with a national population.
Methods: A retrospective study was performed on all KTRs subsequently diagnosed with PCa from a National Kidney Transplant Centre (1994-2016). The primary outcome variables were to compare incidence and 5-year overall survival in KTRs with non-KTRs after treatment of PCa. Secondary outcomes variables were PSA at diagnosis, Gleason grade, treatment strategy and morbidity from treatment among KTRs.
Results: 4048 kidney transplants were performed; of which 3020 (63.9%) were male recipients. In total, 34 (1.1%) KTRs were diagnosed with PCa 109Â±83 months (range 7- 372) after renal transplantation. The age at prostate cancer diagnosis was 64Â±7(range: 53-78) years in KTRs, median PSA was 10 (range: 2.6-771 ng/dL) and 76% (n=26/34) were diagnosed with localised disease. The incidence of PCa was 1,126/100,000 males in KTRs compared to 160/1000,000 males in Ireland (p=0.01). Eighteen patients were treated with curative radiotherapy, 2 underwent curative surgery, 8 were treated with androgen deprivation therapy (ADT) and 6 were managed with watchful waiting (WW) protocols. 1-, 3- and 5-year overall survival rates were not significantly different among KTRs diagnosed with PCa compared to national PCa data (98% Vs 98%, 80% Vs 79% and 77% Vs 72% respectively, p=0.8).
Conclusions: The incidence of PCa is significantly higher among KTRs compared to non KTRs in the general population, with mostly localised disease diagnosed. Outcomes after curative treatment are excellent. Definitive management guidelines should be developed to increase awareness and optimise treatment options in this unique patient cohort.