前列腺癌和固体器官移植：患者管理和结果
Prostate cancer and solid organ transplantation: patient management and outcomes
影响因子:4.40000
分区:医学2区 / 泌尿学与肾脏学2区
发表日期:2025 Feb
作者:
Alon Lazarovich, Tanya W Kristof, Shavano Steadman, Aaron S Dahmen, Michelle A Josephson, Rolf Barth, Todd M Morgan, Marc-Olivier Timsit, Scott Eggener
摘要
分析器官移植前或之后被诊断为前列腺癌的个体的管理和结果，因为器官移植和相关的免疫抑制对前列腺癌的发病率，进展和死亡率的影响仍然是实质性临床兴趣和不确定性的实质性临床探索，并且对固定的器官进行了临床临床构成临床的转移性分析，这些人是临床的转移或临时的临时分析。移植。收集到的数据包括人口统计学和临床信息。该队列由110例前列腺癌诊断时患有中位（四分位范围[IQR]）年龄的患者组成，为62（56.6-67.2）年龄，中位年龄（IQR）年龄为58.6（52.7-65.3）年。肾移植是最常见的（54％）。前列腺癌诊断时的中位（IQR）前列腺特异性抗原浓度为6.2（4.5-10）ng/mL，美国泌尿外科协会风险组的分布为：低风险，36％；中级风险，50％；和高风险，14％。总共有45名（41％）患者在移植前被诊断出患有前列腺癌。管理包括根治性前列腺切除术（RP； 62％），前列腺放射疗法（RT； 13％）和主动监测（AS； 18％）。在前列腺癌诊断的5.8（2.5-10）年的中位随访（IQR）随访期间，一名（2％）患者患有转移性疾病。总共有65名（59％）患者在器官移植后被诊断为前列腺癌。管理为（29％），RT（45％）和RP（15％）。在中位数（IQR）随访5.3（1-8.4）年期间，三名患者（5％）出现转移性疾病。前列腺癌没有死亡。局部前列腺癌的诊断不应排除固体器官移植，并且移植的存在似乎并没有实质上影响前列腺癌进展的风险。
Abstract
To analyse the management and outcomes of individuals diagnosed with prostate cancer either before or after organ transplantation, as the impact of organ transplantation and associated immunosuppression on the incidence, progression, and mortality of prostate cancer remains an area of substantial clinical interest and uncertainty.We conducted a retrospective analysis of patients from two tertiary care centres who had solid organ transplantation and were diagnosed with prostate cancer before or after organ transplantation. Data collected included demographics and clinical information.The cohort consisted of 110 patients with a median (interquartile range [IQR]) age at prostate cancer diagnosis of 62 (56.6-67.2) years and a median (IQR) age at transplantation of 58.6 (52.7-65.3) years. Renal transplantation was the most common (54%). The median (IQR) prostate-specific antigen concentration at prostate cancer diagnosis was 6.2 (4.5-10) ng/mL, and the distribution of American Urological Association risk groups was: low risk, 36%; intermediate risk, 50%; and high risk, 14%. In all, 45 (41%) patients were diagnosed with prostate cancer prior to transplantation. Management included radical prostatectomy (RP; 62%), prostate radiotherapy (RT; 13%), and active surveillance (AS; 18%). During a median (IQR) follow-up of 5.8 (2.5-10) years from prostate cancer diagnosis, one (2%) patient developed metastatic disease. In all, 65 (59%) patients were diagnosed with prostate cancer subsequent to organ transplantation. Management included AS (29%), RT (45%), and RP (15%). During a median (IQR) follow-up of 5.3 (1-8.4) years, three patients (5%) developed metastatic disease. There were no deaths from prostate cancer.A diagnosis of localised prostate cancer should not preclude solid organ transplantation, and the presence of a transplant does not appear to substantially impact risk of prostate cancer progression.