Prostate cancer in renal transplant recipients

Nephrol Dial Transplant. 2008 Jul;23(7):2374-80. doi: 10.1093/ndt/gfn008. Epub 2008 Feb 18.

Abstract

Background: We conducted a retrospective multi-centre study to determine the characteristics of prostate cancer in renal transplant recipients (RTR) and to analyse the relation with immunosuppressive maintenance therapies.

Methods: Patients from 19 French transplant centres diagnosed with prostate cancer at least 1 year after kidney transplantation were included in this study. Data regarding demographics, kidney transplantation, prostate cancer and immunosuppressive treatment were analysed.

Results: Sixty-two patients met the eligibility criteria for this study. Thirty-eight patients (61.3%) received calcineurin inhibitors (CNI) and azathioprine (AZA) with or without steroids, twenty received CNI with or without steroids (32.2%) and four received CNI and mycophenolate mofetil (6.5%). Patients with CNI and AZA immunosuppressive therapy presented more high-stage cancer (T3 and T4) when compared to patients receiving CNI alone (47.5% versus 15%, respectively, P = 0.03). A non-significant increase in lymph node invasion was found in patients receiving CNI and AZA compared to patients receiving CNI alone (21% versus 5%, P = 0.16). In the multivariate analysis, the immunosuppressive regimen with CNI and AZA was the only independent risk factor for locally advanced disease (P = 0.007).

Conclusion: Our results showed that RTR are at risk for early occurrence and for locally advanced prostate cancer, especially when they received a CNI and AZA maintenance immunosuppressive therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Azathioprine / therapeutic use
  • Calcineurin Inhibitors
  • France / epidemiology
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation*
  • Male
  • Mass Screening
  • Middle Aged
  • Multivariate Analysis
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / therapeutic use
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology*
  • Prostatic Neoplasms / immunology
  • Retrospective Studies
  • Risk Factors

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Mycophenolic Acid
  • Azathioprine