Prostate cancer in kidney transplant recipients - a nationwide register study
Autor: | Ola Bratt, Lars Wennberg, Karl-Göran Prütz, Stefan Carlsson, Pär Stattin, Linda Drevin |
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Rok vydání: | 2020 |
Předmět: |
Oncology
medicine.medical_specialty education.field_of_study business.industry Proportional hazards model Urology medicine.medical_treatment Population 030232 urology & nephrology Cancer Immunosuppression Odds ratio medicine.disease Transplantation 03 medical and health sciences Prostate cancer 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Medicine business education Kidney transplantation |
Zdroj: | BJU International. 125:679-685 |
ISSN: | 1464-4096 |
Popis: | Objective To investigate whether post-transplantation immunosuppression negatively affects prostate cancer outcomes in male kidney transplant recipients. Patients and methods We used the Swedish Renal Register and the National Prostate Cancer Register to identify all kidney transplantation recipients diagnosed with prostate cancer in Sweden 1998-2016. After linking these registers with Prostate Cancer Database Sweden (PCBaSe), a case-control study was designed to compare time period and risk category-specific probabilities of a prostate cancer diagnosis amongst kidney transplantation recipients versus the male general population. The registers did not include information about the specific immunosuppression agent used in all transplantation recipients. Data from PCBaSe were used to compare prostate cancer characteristics at diagnosis and survival for patients with prostate cancer with versus without a kidney transplant. Propensity score matching, Cox regression analysis and Fisher's exact test were used and 95% confidence intervals (CIs) calculated. Results Almost half of the 133 kidney transplantation recipients were transplanted before the mid-1990s, when PSA testing became common. The transplant recipients were not more likely than age-matched control men to be diagnosed with any (odds ratio [OR] 0.84, 95% CI 0.70-0.99) or high-risk or metastatic prostate cancer (OR 0.84, 95% CI 0.62-1.13). None of the ORs for the different categories of prostate cancer increased with time since transplantation. Cancer characteristics at the time of diagnosis and cancer-specific survival were similar amongst transplant recipients and the control group of 665 men diagnosed with prostate cancer without a kidney transplant. Conclusions This Swedish nationwide, register-based study gave no indication that immunosuppression after kidney transplantation increases the risk of prostate cancer or adversely affects prostate cancer outcomes. The study suggests that men with untreated low-grade prostate cancer can be accepted for transplantation. |
Databáze: | OpenAIRE |
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