Clinic for Urology and Kidney Transplantation Centre, Martin Luther University Halle/Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle, Germany.
Nephrol Dial Transplant. 2010 Oct;25(10):3416-20. doi: 10.1093/ndt/gfq193. Epub 2010 Apr 12.
The study aimed to report our experience with retropubic radical prostatectomy (RRP) for treatment of localized prostate cancer in renal transplant recipients (RTR).
Data of 16 RTR who had an RRP between 2001 and 2007 were retrospectively analysed and compared to the data of 294 non-transplanted patients who were operated for RRP during the same period. Diagnostic work-up consisted of digital rectal examination, serum prostate specific antigene levels, as well as Transrectal Ultrasonography (TRUS)-guided prostate biopsy. Follow-up was obtained in all patients with a mean follow-up time of 2.1 years in RTR.
Mean time distance to the renal transplantation at the time of RRP was 81.2 ± 19.1 months. RRP was successfully performed and tolerated in all RTR without pelvic lymph node dissection. No major complications occurred during or after the operation. There were two minor complications in transplant group (prolonged haematuria and urinary leakage). Mean operative time was 108.3 ± 3.9 min in transplant group, which was significantly longer as in non-transplanted group (89.1 ± 4.1, P < 0.05). Mean estimated intra-operative blood loss was significantly lower in transplant group (P < 0.05). In RTR, one case of positive surgical margins was present (R(1): 6.2 vs. 12.3% in non-transplanted group, P < 0.05). None of the RTR had impairment of graft function. At follow-up, no case of biochemical recurrence was observed in RTR.
RRP is safe and feasible for management of localized prostate cancer in patients with kidney allograft being under immunosuppression. However, concern about impairment of graft function, infection and wound healing remains important.
本研究旨在报告我们在肾移植受者（RTR）中应用经耻骨后根治性前列腺切除术（RRP）治疗局限性前列腺癌的经验。
回顾性分析了 2001 年至 2007 年间 16 例接受 RRP 的 RTR 患者的数据，并与同期接受 RRP 治疗的 294 例非移植患者的数据进行了比较。诊断方法包括直肠指检、血清前列腺特异抗原水平以及经直肠超声（TRUS）引导下前列腺活检。所有患者均获得随访，RTR 患者的平均随访时间为 2.1 年。
RRP 时距肾移植的平均时间间隔为 81.2 ± 19.1 个月。所有 RTR 患者均成功完成手术，无需行盆腔淋巴结清扫术。手术中和手术后均无重大并发症。移植组有 2 例轻微并发症（血尿时间延长和尿漏）。移植组的平均手术时间为 108.3 ± 3.9 分钟，明显长于非移植组（89.1 ± 4.1，P < 0.05）。移植组术中估计失血量明显较低（P < 0.05）。在 RTR 中，1 例切缘阳性（R（1）：6.2%比非移植组的 12.3%，P < 0.05）。无 RTR 出现移植物功能损害。随访期间，RTR 无一例发生生化复发。
RRP 是一种安全可行的治疗方法，可用于治疗接受免疫抑制治疗的肾移植受者的局限性前列腺癌。然而，对移植物功能损害、感染和伤口愈合的担忧仍然很重要。
