Management of localized prostate cancer by retropubic radical prostatectomy in patients after renal transplantation
Autor: | A. Hamza, Hans Heynemann, Olaf Reichelt, M. Raschid Hoda, Sigrid Wagner, Paolo Fornara, Kersten Fischer, Francesco Greco |
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Rok vydání: | 2010 |
Předmět: |
Male
Biochemical recurrence medicine.medical_specialty Prostate biopsy medicine.medical_treatment Urology Prostate cancer medicine Humans Kidney transplantation Aged Retrospective Studies Immunosuppression Therapy Prostatectomy Transplantation medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged medicine.disease Kidney Transplantation Surgery Nephrology Transrectal ultrasonography business Kidney disease |
Zdroj: | Nephrology Dialysis Transplantation. 25:3416-3420 |
ISSN: | 1460-2385 0931-0509 |
Popis: | Background. The study aimed to report our experience with retropubic radical prostatectomy (RRP) for treatment of localized prostate cancer in renal transplant recipients (RTR). Methods. 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. Results. 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 nontransplanted 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 positivesurgical margins was present (R1: 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. Conclusions. 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. |
Databáze: | OpenAIRE |
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