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肾移植评估时新诊断前列腺癌的影响。

Impact of newly diagnosed prostate cancer at time of evaluation for renal transplantation.

作者信息

Poinard Florence, Bessede Thomas, Barrou Benoit, Drouin Sarah, Karam Georges, Branchereau Julien, Alezra Eric, Thuret Rodolphe, Verhoest Gregory, Goujon Anna, Millet Clementine, Boissier Romain, Delaporte Veronique, Sallusto Federico, Prudhomme Thomas, Boutin Jean-Michel, Culty Thibaut, Timsit Marc-Olivier

机构信息

Department of Urology and Renal Transplantation, Georges Pompidou European Hospital, Paris, France.

Urology Department, Hopitaux Universitaires Paris-Sud, Le Kremlin-Bicetre, France.

出版信息

Clin Transplant. 2023 Sep;37(9):e14998. doi: 10.1111/ctr.14998. Epub 2023 May 3.

Abstract

Systematic screening for prostate cancer is widely recommended in candidates for renal transplant at the time of listing. There are concerns that overdiagnosis of low-risk prostate cancer may result in reducing access to transplant without demonstrated oncological benefits. The objective of the study was to assess the outcome of newly diagnosed prostate cancer in candidates for transplant at the time of listing, and its impact on transplant access and transplant outcomes according to treatment options. This retrospective study was conducted over 10 years in 12 French transplant centers. Patients included were candidates for renal transplant at the time of prostate cancer diagnosis. Demographical and clinical data regarding renal disease, prostate cancer, and transplant surgery were collected. The primary outcome of the study was the interval between prostate cancer diagnosis and active listing according to treatment options. Overall median time from prostate cancer diagnosis to active listing was 25.0 months [16.4-40.2], with statistically significant differences in median time between the radiotherapy and the active surveillance groups (p = .03). Prostate cancer treatment modalities had limited impact on access and outcome of renal transplantation. Active surveillance in low-risk patients does not seem to compromise access to renal transplantation, nor does it impact oncological outcomes.

摘要

在肾移植候选人登记时,广泛推荐对前列腺癌进行系统筛查。有人担心,低风险前列腺癌的过度诊断可能会导致在没有明确肿瘤学益处的情况下减少移植机会。本研究的目的是评估登记时新诊断的前列腺癌在移植候选人中的转归,以及根据治疗方案评估其对移植机会和移植结果的影响。这项回顾性研究在法国的12个移植中心进行了10年。纳入的患者为前列腺癌诊断时的肾移植候选人。收集了有关肾脏疾病、前列腺癌和移植手术的人口统计学和临床数据。该研究的主要结局是根据治疗方案,前列腺癌诊断与正式登记之间的间隔时间。从前列腺癌诊断到正式登记的总体中位时间为25.0个月[16.4 - 40.2],放疗组和主动监测组之间的中位时间存在统计学显著差异(p = 0.03)。前列腺癌的治疗方式对肾移植的机会和结果影响有限。对低风险患者进行主动监测似乎不会影响肾移植机会,也不会影响肿瘤学结局。

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