Relatively longer time on a kidney transplant wait list is associated with an increased risk of death among men who had received prior curative treatment for prostate cancer (PCa), investigators reported at the 2019 American Transplant Congress in Boston.
Using the US Renal Data System database, Nagaraju Sarabu, MD, MPH, of University Hospitals of Cleveland in Ohio, and colleagues identified 920 men who received kidney transplants and had a history of having undergone prostatectomy or radiation treatment for PCa. Dr Sarabu’s team stratified the men according to waiting time: 0 to 2 years, 2 to 5 years, and more than 5 years.
Compared with a waiting time of 0 to 2 years, a waiting time greater than 5 years was associated with a significant 73% increased risk of death. A wait time of 2 to 5 years was associated with a nonsignificant 13% increased risk of death.
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Men who underwent prostatectomy rather than radiation had better a significant 60% decreased risk of post-transplant death.
For the study, Dr Sarabu and his collaborators used propensity scoring to adjust for baseline variables among the patients.
“Prostatectomy and kidney transplant without significant delay may be optimal choices for patients with prostate cancer who are eligible for [a] kidney transplant,” the authors concluded in their study abstract.
Study findings suggest that prostatectomy may be the preferred choice of therapy for men with end-stage renal disease, Dr Sarabu told Renal & Urology News. In addition, unlike other solid organ tumors that require a certain period of surveillance for recurrence, PCa likely does not require such waiting time. “This is important since dialysis is associated with higher morbidity and mortality compared to those who receive kidney transplants.”
Reference
Sarabu N, Schiltz N, Chavin KD, Hricik DE. The more you wait, the more you lose: Prostatectomy and kidney transplant waiting time in end stage renal disease. Presented at the 2019 American Transplant Congress in Boston, June 1 to 5. Abstract 324.
