Prostate Cancer Surgery Feasible in Kidney Transplant Recipients – Renal and Urology News

Radical prostatectomy for prostate cancer can be performed in kidney transplant recipients, but the procedure poses significant challenges to these patients, according to investigators.

Giancarlo Marra, MD, of AOU Città della Salute e della Scienza and the University of Turin in Italy, and colleagues compared outcomes between 102 kidney transplant recipients and 408 non-transplant patients who underwent radical prostatectomy. Compared with other patients, kidney transplant recipients had significantly higher rates of estimated blood loss (400 vs 200 mL) and postoperative complication rates (12% vs 3%). They also had longer hospital stays (6 vs 3.5 days), longer times to catheter removal (11 vs 5 days), and a lower continence recovery rate (75% vs 89%).

On multivariable analyses, kidney transplant status independently predicted 22%, 57%, 124%, and 93% increased odds of longer operative time, longer length of stay, greater estimated blood loss, and longer time to catheter removal, respectively, but not complications or continence recovery, Dr Marra’s team reported in European Urology Focus.

The investigators also found no significant differences in oncologic outcomes, including biochemical recurrence and local or systemic progression between patients with and without a kidney transplant.

The overall death rate from all causes, however, was significantly higher in the kidney transplant group (17% vs 0.5%).

“When localized, PCa is not a major driver of mortality in the [kidney transplant] population and has only a marginal influence on survival,” according to Dr Marra’s team. “Despite important advances in [kidney transplant] care, morbidity rather than PCa influences life expectancy in this population.”

For these reasons, the investigators urged “careful selection” of kidney transplant recipients for radical prostatectomy.