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肾移植术后前列腺癌的诊断与治疗

[Diagnostics and treatment of prostate cancer after kidney transplantation].

作者信息

Wicht A, Hamza A, Loertzer H, Dietl M, Heynemann H, Fornara P

机构信息

Klinik und Poliklinik für Urologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Strasse 40, 06097 Halle/Saale.

出版信息

Urologe A. 2006 Jan;45(1):32-7. doi: 10.1007/s00120-005-0961-y.

Abstract

The number of patients with prostate cancer and end-stage renal disease or prostate cancer following kidney transplantation has continuously increased in industrialized countries. According to the data generated by Penn et al. a higher incidence of prostate cancer following kidney transplantation can be seen but is probably due to a more intense screening of the recipients. It is rather a common opinion that no elevated risk of prostate cancer following kidney transplantation exists. In patients with strictly localized prostate cancer curative treatment should be the aim also after kidney transplantation. Kidney transplantation does not interfere with surgical access to the prostate gland (retropubic or perineal). Nonlocal tumors of the prostate should also be treated following the general recommendations regarding prostate cancer. Looking at the current literature, a reduction or change of immunosuppression seems reasonable. It is necessary to establish a nationwide (or even European) cancer register, especially for patients before and after transplantation.

摘要

在工业化国家,患有前列腺癌以及终末期肾病或肾移植后发生前列腺癌的患者数量持续增加。根据Penn等人的数据,肾移植后前列腺癌的发病率较高,但这可能是由于对受者的筛查更为严格。相当普遍的观点是,肾移植后不存在前列腺癌风险升高的情况。对于局限性前列腺癌患者,肾移植后也应以根治性治疗为目标。肾移植并不影响经耻骨后或会阴途径对前列腺进行手术。前列腺的非局限性肿瘤也应按照前列腺癌的一般建议进行治疗。从目前的文献来看,减少或改变免疫抑制似乎是合理的。有必要建立一个全国性(甚至欧洲范围)的癌症登记系统,特别是针对移植前后的患者。

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