Prostate Cancer Need Not Preclude Kidney Transplants

ORLANDO, Fla.—Early kidney transplantation in patients with prostate cancer (PCa) is associated with improved survival compared with remaining on hemodialysis (HD), researchers reported at the National Kidney Foundation's 2013 Spring Clinical Meetings.

Thet Zaw, MD, and colleagues at Newark Beth Israel Medical Center in Newark, N.J., noted that for patients on HD to be eligible for a kidney transplant, they must have a two-year cancer-free period immediately preceding transplantation. The purpose of their study was to determine if some patients with PCa would be better served by undergoing kidney transplantation rather than waiting for two years to be declared cancer-free.

Dr. Zaw's group studied 30 kidney transplant recipients diagnosed with PCa prior to transplantation. Their five-year mortality rate was 3.3%. By comparison, HD patients have a five-year mortality rate of 73.6%, according to 2000-2007 data from the U.S. Renal Data System.

The researchers concluded that PCa should not preclude kidney transplantation “since slow growth and early detection carries a good prognosis.” Surgery and radiation therapy may be curative treatments for localized tumors, they noted.

In a separate study also presented at the meeting, Dr. Zaw and collaborators found that surgery and radiation treatment for PCa in kidney transplant patients are associated with similar survival.

In a retrospective analysis of the United Network of Organ Sharing (UNOS) database from January 2000 to June 2012, the investigators identified 396 kidney transplant patients who had received surgery or radiation therapy for PCa. Patients were classified according to choice of treatment and treatment outcomes. A total of 156 patients underwent surgery, 211 had radiation therapy, and 29 had both.

By the end of the study period, the surviving patients included 150 (96%) of 156 who had undergone surgery, 206 (98%) of 211 who had received radiation therapy, and 27 (93%) of 29 who had both.

The authors noted that both studies were limited by the unavailability of histopathologic staging, and that a larger study with longer follow up is needed to confirm the findings.

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