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804 Radical prostatectomy in transplant patients
Title
804
Radical prostatectomy in transplant patients Eur Urol Suppl 2015;14/2;e804
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Beyer B., Steuber T., Schriefer P., Michl U., Heinzer H., Schlomm T., Huland H., Graefen M., Tilki D. University Medical Center Hamburg-Eppendorf, Martini-Clinic, Prostate Cancer Center, Hamburg, Germany INTRODUCTION & OBJECTIVES: Oncologic surgery in immunosuppressed patients with solid organ transplantation (Tx) is challenging. These patients are thought to have higher postoperative morbidity and an increased rate of tumour progression. Aim of the study was a retrospective analysis of perioperative outcome and tumour-specific morbidity and mortality in Tx patients following radical prostatectomy (RP). MATERIAL & METHODS: Between 1996 and 2014 RP was performed on 30 patients diagnosed with PCa following Tx (kidney Tx: n=20, heart Tx: n=5, liver Tx: n=5) at our institution. The median follow-up was 45 months. Postoperative complications were assessed with the Clavien-Dindo Classification. RESULTS: Median age at PCa diagnosis was 64 years (51-73). Median PSA at diagnosis was 5.3 ng/ml (1.0-250.0). Median intraoperative blood loss was 600 ml (100 ml – 1600 ml) at a median operating time of 180 min (120 – 285 min). Surgery in kidney tx patients was technically feasible. Major complications occured in 3 patients (urethral injury, lymphocele, hematoma). Histological evaluation revealed n=18 ≤pT2 tumours (60.0%), n=7 pT3a tumours (23.3%) and n=5 ≥pT3b tumours (16.7%). Continence rate at 12 months was 70.0% (n=21) defined as no pad use and 90.0% (n=27) for ≤ 2 pads / 24h. This rate is lower than in other prostatectomy series due to comorbidities of Tx patients. After a median follow-up of 45 months BCR-free survival was 70.0%. In recurrent patients there was no evidence of metastasis or cancer-specific death. Overall survival was 86.6%. CONCLUSIONS: The complication rate in patients with solid organ transplantation after radical prostatectomy was low. Histopathological evaluation revealed disease characteristics comparable to current RP series. Immunosuppressive therapy therefore does not seem to lead to an increased rate of tumour progression.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/804.html[19/02/2015 08:21:04]
804
Radical prostatectomy in transplant patients Eur Urol Suppl 2015;14/2;e804
Print! Print!
Beyer B., Steuber T., Schriefer P., Michl U., Heinzer H., Schlomm T., Huland H., Graefen M., Tilki D. University Medical Center Hamburg-Eppendorf, Martini-Clinic, Prostate Cancer Center, Hamburg, Germany INTRODUCTION & OBJECTIVES: Oncologic surgery in immunosuppressed patients with solid organ transplantation (Tx) is challenging. These patients are thought to have higher postoperative morbidity and an increased rate of tumour progression. Aim of the study was a retrospective analysis of perioperative outcome and tumour-specific morbidity and mortality in Tx patients following radical prostatectomy (RP). MATERIAL & METHODS: Between 1996 and 2014 RP was performed on 30 patients diagnosed with PCa following Tx (kidney Tx: n=20, heart Tx: n=5, liver Tx: n=5) at our institution. The median follow-up was 45 months. Postoperative complications were assessed with the Clavien-Dindo Classification. RESULTS: Median age at PCa diagnosis was 64 years (51-73). Median PSA at diagnosis was 5.3 ng/ml (1.0-250.0). Median intraoperative blood loss was 600 ml (100 ml – 1600 ml) at a median operating time of 180 min (120 – 285 min). Surgery in kidney tx patients was technically feasible. Major complications occured in 3 patients (urethral injury, lymphocele, hematoma). Histological evaluation revealed n=18 ≤pT2 tumours (60.0%), n=7 pT3a tumours (23.3%) and n=5 ≥pT3b tumours (16.7%). Continence rate at 12 months was 70.0% (n=21) defined as no pad use and 90.0% (n=27) for ≤ 2 pads / 24h. This rate is lower than in other prostatectomy series due to comorbidities of Tx patients. After a median follow-up of 45 months BCR-free survival was 70.0%. In recurrent patients there was no evidence of metastasis or cancer-specific death. Overall survival was 86.6%. CONCLUSIONS: The complication rate in patients with solid organ transplantation after radical prostatectomy was low. Histopathological evaluation revealed disease characteristics comparable to current RP series. Immunosuppressive therapy therefore does not seem to lead to an increased rate of tumour progression.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/804.html[19/02/2015 08:21:04]