Culty T, Goujon A, Defortescu G, Bessede T, Kleinclauss F, Boissier R, Drouin S, Branchereau J, Doerfler A, Prudhomme T, Matillon X, Verhoest G, Tillou X, Ploussard G, Rozet F, Méjean A, Timsit M-O
Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
Comité de transplantation et d'insuffisance rénale chronique de l'Association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
Prog Urol. 2021 Jan;31(1):4-17. doi: 10.1016/j.purol.2020.04.027.
To define guidelines for the management of localized prostate cancer (PCa) in kidney transplant (KTx) candidates and recipients.
A systematic review (Medline) of the literature was conducted by the CTAFU to report prostate cancer epidemiology, screening, diagnosis and management in KTx candidates and recipients with the corresponding level of evidence.
KTx recipients are at similar risk for PCa as general population. Thus, PCa screening in this setting is defined according to global French guidelines from CCAFU. Systematic screening is proposed in candidates for renal transplant over 50 y-o. PCa diagnosis is based on prostate biopsies performed after multiparametric MRI and preventive antibiotics. CCAFU guidelines remain applicable for PCa treatment in KTx recipients with some specificities, especially regarding lymph nodes management. Treatment options in candidates for KTx need to integrate waiting time and access to transplantation. Current data allows the CTAFU to propose mandatory waiting times after PCa treatment in KTx candidates with a weak level of evidence.
These French recommendations should contribute to improve PCa management in KTx recipients and candidates, integrating oncological objectives with access to transplantation.
制定肾移植（KTx）候选者及接受者中局限性前列腺癌（PCa）管理的指南。
CTAFU对文献进行了系统综述（Medline），以报告KTx候选者及接受者中前列腺癌的流行病学、筛查、诊断和管理情况，并给出相应的证据水平。
KTx接受者患PCa的风险与普通人群相似。因此，这种情况下的PCa筛查是根据CTAFU的法国总体指南来定义的。建议对50岁以上的肾移植候选者进行系统筛查。PCa诊断基于多参数MRI及预防性抗生素治疗后进行的前列腺活检。CTAFU指南在KTx接受者的PCa治疗中仍然适用，但有一些特殊性，特别是在淋巴结管理方面。KTx候选者的治疗选择需要综合考虑等待时间和移植机会。目前的数据使CTAFU能够在证据水平较弱的情况下，对KTx候选者PCa治疗后的强制等待时间提出建议。
这些法国建议应有助于改善KTx接受者和候选者的PCa管理，将肿瘤学目标与移植机会相结合。
