Prostate cancer in renal transplant recipients

Background. We conducted a retrospective multi-centre study to determine the characteristics of prostate cancer in renal transplant recipients (RTR) and to analyse the relation with immunosuppressive maintenance therapies. Methods. Patients from 19 French transplant centres diagnosed with prostate cancer at least 1 year after kidney transplantation were included in this study. Data regarding demographics, kidney transplantation, prostate cancer and immunosuppressive treatment were analysed. Results. Sixty-two patients met the eligibility criteria for this study. Thirty-eight patients (61.3%) received calcineurin inhibitors (CNI) and azathioprine (AZA) with or without steroids, twenty received CNI with or without steroids (32.2%) and four received CNI and mycophenolate mofetil (6.5%). Patients with CNI and AZA immunosuppressive therapy presented more high-stage cancer (T3 and T4) when compared to patients receiving CNI alone (47.5% versus 15%, respectively, P = 0.03). A non-significant increase in lymph node invasion was found in patients receiving CNI and AZA compared to patients receiving CNI alone (21% versus 5%, P = 0.16). In the multivariate Correspondence and offprint requests to: François Kleinclauss, Department of Urology and Renal Transplantation, INSERM U645, University Hospital of Besançon, 2 place Saint Jacques, F-25000 Besançon, France. Tel: +33-3-81-21-91-70; Fax: +33-3-81-21-91-73; E-mail: [email protected] ∗Members of the Renal Transplantation Committee of the French Urological Association: L. Albano (Nice), L. Badet (Lyon), B. Barrou (Paris), G. Benoit (Paris), K. Bensalah (Rennes), M.O. Bitker (Paris), P. Blanchet (Pointe à Pitre), E. Chartier Kastler (Paris), L. Cormier (Nancy), V. Delaporte (Marseille), B. Doré (Poitiers), B. Feuillu (Nancy), M. Gigante (Nice), P. Grise (Rouen), L. Guy (Clermont Ferrand), J. Hubert (Nancy), F. Iborra (Montpellier), V. Joulin (Brest). G. Karam (Nantes), F. Kleinclauss (Besançon), E. Lechevallier (Marseille), X. Martin (Lyon), V. Moal (Paris), M.C. Moal (Brest), P. Mongiat-Arthus (Paris), M. Mouzin (Toulouse), Y. Neuzillet (Marseille), J. Petit (Amiens), M. Peyromaure (Paris), J.J. Rambeaud (Grenoble), L. Salomon (Creteil), F. Sallusto (Toulouse), N. Terrier (Grenoble), N. Thiounn (Paris), X. Tillou (Amiens), C. Vassen (Paris), P. Wolf (Strasbourg). analysis, the immunosuppressive regimen with CNI and AZA was the only independent risk factor for locally advanced disease (P = 0.007). Conclusion. Our results showed that RTR are at risk for early occurrence and for locally advanced prostate cancer, especially when they received a CNI and AZA maintenance immunosuppressive therapy.