Prostatectomy for localized prostate cancer to prepare for renal transplantation in end-stage renal disease patients.

Background: Surgical difficulties of renal transplantation related to prostate cancer (PC) treatment and the results of renal transplantation after radical prostatectomy are currently poorly known, as well as oncological follow-up before and after renal transplantation.
Material/methods: We performed a retrospective study including all patients diagnosed with PC before renal transplantation in our department.
Results: Nineteen patients were included between August 2003 and December 2013. The mean age at diagnosis of PC was 61.7 years (range 51.4-71.1). PSA mean level at diagnosis was 8.5 ng/ml (range 4.8-20). Fourteen had a retro-pubic and 5 a laparoscopic prostatectomy. Three patients underwent radiotherapy for positive surgical margins or extra-capsular extension. Fourteen patients were transplanted. The mean time lapse between prostatectomy and kidney transplantation was 32.8 months (range 14-71). Seven recipients (50%) were transplanted less than 24 months after prostatectomy. Post-transplantation surgical complications were not significantly related to dissection difficulties (p=0.2). No recurrence of PC was observed after renal transplantation, with a mean follow-up of 38 months (range 6-77.9).
Conclusions: Prostate cancer discovered before renal transplantation should be treated by radical prostatectomy to assess recurrence risk. If the PC is at low risk of recurrence, it seems possible to shorten the 2-year period of oncologic follow-up before transplantation called for in current recommendations.