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01-08-2016 | Original Article

Oncological, functional and perioperative outcomes in transplant patients after radical prostatectomy

Authors: Burkhard Beyer, Philipp Mandel, Uwe Michl, Raisa S. Pompe, Valia Veleva, Thomas Steuber, Hartwig Huland, Markus Graefen, Derya Tilki

Published in: World Journal of Urology | Issue 8/2016

Abstract

Purpose

Oncological 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. The aim of the present study was to analyse oncological, functional and perioperative outcomes in Tx patients following radical prostatectomy (RP).

Materials and methods

Between 1996 and 2014, 30 patients diagnosed with prostate cancer underwent RP at our institution following Tx (kidney: n = 20, heart: n = 5, liver: n = 5). Functional, oncological and perioperative follow-ups were analysed. Postoperative complications were assessed using the Clavien–Dindo classification.

Results

Median follow-up was 45 months. Median PSA was 5.3 ng/ml. Intraoperative blood loss was 600 ml at a median operating time of 180 min. Surgery in kidney Tx patients was technically feasible. Major complications occurred in 3 patients (ureteral injury, lymphocele and haematoma). Histological evaluation revealed n = 18 ≤pT2 tumours (60.0 %), n = 7 pT3a tumours (23.3 %) and n = 5 ≥pT3b tumours (16.7 %). Continence rate 12 months after surgery, defined as no or one safety pad use, was 73.3 %, while 93.3 % of the patients used ≤2 pads/24 h. After the median follow-up of 45 months, BCR-free survival was 69.0 %. In recurrent men, there was suspicion of metastasis in one patient. No cancer-specific death was observed. Five-year overall survival was 94.4 %.

Conclusion

The complication rate in patients with solid organ transplantation after RP was low. While histopathological evaluation revealed disease characteristics comparable to non-transplant patients from current RP series, postoperative continence was worse. Immunosuppressive therapy does not seem to lead to an increased rate of tumour progression.

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Title: Oncological, functional and perioperative outcomes in transplant patients after radical prostatectomy
Authors: Burkhard Beyer
Philipp Mandel
Uwe Michl
Raisa S. Pompe
Valia Veleva
Thomas Steuber
Hartwig Huland
Markus Graefen
Derya Tilki
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 8/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1758-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Oncological, functional and perioperative outcomes in transplant patients after radical prostatectomy

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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