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NDT Advance Access published online on February 18, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn008
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Prostate cancer in renal transplant recipients

François Kleinclauss1,2, Marc Gigante1,3, Yann Neuzillet1,4, Marc Mouzin1,5, Nicolas Terrier1,6, Laurent Salomon1,7, François Iborra1,8, Jacques Petit1,9, Luc Cormier1,10, Eric Lechevallier1,4 and for the Renal Transplantation Committee of the French Urological Association (AFU)*

1 Renal Transplantation Committee of the French Urological Association, Paris 2 Department of Urology, University Hospital Saint Jacques, INSERM U645, Besançon 3 Department of Urology, University Hospital of Nice, Nice 4 Department of Urology, University Hospital Salvator, Marseille 5 Department of Urology, University Hospital Rangueil, Toulouse 6 Department of Urology, University Hospital, Grenoble 7 Department of Urology, University Hospital Mondor, Creteil 8 Department of Urology, University Hospital Lapeyronie, Montpellier 9 Department of Urology, University Hospital Sud, Amiens 10 Department of Urology, University Hospital Nancy-Brabois, Nancy, France

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: francois.kleinclauss{at}univ-fcomte.fr



  Abstract

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 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.

Keywords: cancer; immunosuppression; kidney; prostate; transplantation

* 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).

Received for publication: 10.10.07
Accepted in revised form: 4. 1.08


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