ObjectiveTo 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.Patients and MethodsWe 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.ResultsThe 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.ConclusionA 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.

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前列腺癌和实体器官移植：患者管理和结局


目的分析器官移植前后被诊断患有前列腺癌的个体的管理和结局，因为器官移植和相关免疫抑制对前列腺癌发病率、进展和死亡率的影响仍然是一个具有重大临床关注和不确定性的领域。患者和方法我们对来自两个三级医疗中心的患者进行了回顾性分析，这些患者接受了实体器官移植，并在器官移植前后被诊断患有前列腺癌。收集的数据包括人口统计学和临床信息。结果该队列由 110 名患者组成，前列腺癌诊断时的中位 （四分位距 [IQR]）年龄为 62 （56.6-67.2） 岁，移植时的中位 （IQR） 年龄为 58.6 （52.7-65.3） 岁。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分布为：低风险，36%;中等风险，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。治疗包括根治性前列腺切除术 （RP; 62%）、前列腺放疗 （RT; 13%） 和主动监测 （AS; 18%）。在前列腺癌诊断后 5.8 （2.5-10） 年的中位 （IQR） 随访期间，一名 （2%） 患者发展为转移性疾病。总共有 65 名 （59%） 患者在器官移植后被诊断出患有前列腺癌。治疗包括 AS （29%） 、 RT （45%） 和 RP （15%）。在 5.3 （1-8.4） 年的中位 （IQR） 随访期间，3 名患者 （5%） 发展为转移性疾病。没有死于前列腺癌的病例。结论局限性前列腺癌的诊断不应排除实体器官移植，并且移植的存在似乎不会对前列腺癌进展的风险产生重大影响。