TY - JOUR
T1 - Prostate Cancer Screening and Treatment in the Transplant Population
T2 - Current Status and Recommendations
AU - Breyer, Benjamin N.
AU - Whitson, Jared M
AU - Freise, Christopher E.
AU - Meng, Maxwell V.
PY - 2009/5
Y1 - 2009/5
N2 - Purpose: We reviewed the current status of and recommendations for prostate cancer screening and treatment in the solid organ transplant population. Materials and Methods: We performed a MEDLINE® search to identify published data regarding prostate cancer screening, risk, treatment and outcomes in the solid organ transplant population. The literature was reviewed and summarized. Results: Most data regarding outcomes of prostate cancer treatment in the transplant population are limited to case reports and small series, and primarily involve renal insufficiency. It does not appear that the development or natural history of prostate cancer is significantly affected by organ failure or subsequent transplantation. Thus, prostate specific antigen testing and screening protocols can be extrapolated from the general population. However, the balance of comorbid diseases and estimated limitations in life expectancy must be carefully considered, and emphasis should be placed on risk assessment. Prostatectomy appears to be feasible with outcomes comparable to those in the non-transplant population, while data regarding the use of radiation therapy are limited. Conclusions: The expansion of organ transplant criteria, including older donors and recipients, combined with improved allograft survival has enhanced the relevance of prostate cancer screening and treatment in this group. Greater awareness of the issues surrounding prostate cancer incidence, detection and natural history should promote improved data collection, screening and treatment of prostate cancer in the transplant population.
AB - Purpose: We reviewed the current status of and recommendations for prostate cancer screening and treatment in the solid organ transplant population. Materials and Methods: We performed a MEDLINE® search to identify published data regarding prostate cancer screening, risk, treatment and outcomes in the solid organ transplant population. The literature was reviewed and summarized. Results: Most data regarding outcomes of prostate cancer treatment in the transplant population are limited to case reports and small series, and primarily involve renal insufficiency. It does not appear that the development or natural history of prostate cancer is significantly affected by organ failure or subsequent transplantation. Thus, prostate specific antigen testing and screening protocols can be extrapolated from the general population. However, the balance of comorbid diseases and estimated limitations in life expectancy must be carefully considered, and emphasis should be placed on risk assessment. Prostatectomy appears to be feasible with outcomes comparable to those in the non-transplant population, while data regarding the use of radiation therapy are limited. Conclusions: The expansion of organ transplant criteria, including older donors and recipients, combined with improved allograft survival has enhanced the relevance of prostate cancer screening and treatment in this group. Greater awareness of the issues surrounding prostate cancer incidence, detection and natural history should promote improved data collection, screening and treatment of prostate cancer in the transplant population.
KW - graft survival
KW - prostate-specific antigen
KW - prostatic neoplasms
KW - transplantation
UR - http://www.scopus.com/inward/record.url?scp=64049084828&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64049084828&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2009.01.021
DO - 10.1016/j.juro.2009.01.021
M3 - Review article
C2 - 19286214
AN - SCOPUS:64049084828
VL - 181
SP - 2018
EP - 2026
JO - Investigative Urology
JF - Investigative Urology
SN - 0022-5347
IS - 5
ER -