Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation
Solid organ transplant (SOT) candidates and recipients are often subject to intense screening regimens that can potentially delay transplantation and cause unnecessary harm. Although initial studies suggested that SOT recipients had elevated risk of prostate cancer (PCa), contemporary studies have s...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168322000520 |
| _version_ | 1818009496808587264 |
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| author | Zorawar Singh Sarah K. Holt John L. Gore Yaw A. Nyame Jonathan L. Wright George R. Schade |
| author_facet | Zorawar Singh Sarah K. Holt John L. Gore Yaw A. Nyame Jonathan L. Wright George R. Schade |
| author_sort | Zorawar Singh |
| collection | DOAJ |
| description | Solid organ transplant (SOT) candidates and recipients are often subject to intense screening regimens that can potentially delay transplantation and cause unnecessary harm. Although initial studies suggested that SOT recipients had elevated risk of prostate cancer (PCa), contemporary studies have shown that transplant recipients with low- or intermediate-risk PCa have similar outcomes to their counterparts without a transplant. However, there are limited data on the relationship between prior transplant exposure and the risk of clinically significant aggressive PCa at presentation. To provide additional insight, we queried the Surveillance, Epidemiology and End Results-Medicare database to establish a cohort of prostate-specific antigen (PSA)-screened transplant patients who then went on to develop PCa. Procedure and diagnosis codes were then used to identify patients with a history of SOT. Aggressive PCa phenotype was defined as death from PCa or de novo metastasis, regional lymph node metastasis, PSA >20 ng/l, or Gleason score 8–10 at presentation. On univariable and multivariable (adjusted for age and race) analyses, transplant patients (n = 292) were not at significantly higher risk of an aggressive prostate cancer phenotype with odds ratios of 0.95 (95% confidence interval 0.72–1.25) and 1.18, (95% confidence interval 0.90–1.57), respectively. The results suggest that transplant recipients can have similar screening protocols to those for the general population. Patient summary: Using database results for transplant recipients, we investigated their risk of developing aggressive prostate cancer after transplantation. We found that having a transplant did not increase the risk of aggressive prostate cancer. This work suggests that transplant recipients are unlikely to benefit from more rigorous screening protocols than those for the general population. |
| first_indexed | 2024-04-14T05:43:36Z |
| format | Article |
| id | doaj.art-0521ec179ce342b9b793c7c2aedbb39a |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-14T05:43:36Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-0521ec179ce342b9b793c7c2aedbb39a2022-12-22T02:09:21ZengElsevierEuropean Urology Open Science2666-16832022-05-01397982Aggressive Prostate Cancer at Presentation Following Solid Organ TransplantationZorawar Singh0Sarah K. Holt1John L. Gore2Yaw A. Nyame3Jonathan L. Wright4George R. Schade5Department of Urology, University of Washington Medical Center, Seattle, WA, USA; Division of Urology, Albany Medical College, Albany, NY, USADepartment of Urology, University of Washington Medical Center, Seattle, WA, USADepartment of Urology, University of Washington Medical Center, Seattle, WA, USADepartment of Urology, University of Washington Medical Center, Seattle, WA, USADepartment of Urology, University of Washington Medical Center, Seattle, WA, USADepartment of Urology, University of Washington Medical Center, Seattle, WA, USA; Corresponding author at: Department of Urology, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195, USA. Tel. +1 206 7973722.Solid organ transplant (SOT) candidates and recipients are often subject to intense screening regimens that can potentially delay transplantation and cause unnecessary harm. Although initial studies suggested that SOT recipients had elevated risk of prostate cancer (PCa), contemporary studies have shown that transplant recipients with low- or intermediate-risk PCa have similar outcomes to their counterparts without a transplant. However, there are limited data on the relationship between prior transplant exposure and the risk of clinically significant aggressive PCa at presentation. To provide additional insight, we queried the Surveillance, Epidemiology and End Results-Medicare database to establish a cohort of prostate-specific antigen (PSA)-screened transplant patients who then went on to develop PCa. Procedure and diagnosis codes were then used to identify patients with a history of SOT. Aggressive PCa phenotype was defined as death from PCa or de novo metastasis, regional lymph node metastasis, PSA >20 ng/l, or Gleason score 8–10 at presentation. On univariable and multivariable (adjusted for age and race) analyses, transplant patients (n = 292) were not at significantly higher risk of an aggressive prostate cancer phenotype with odds ratios of 0.95 (95% confidence interval 0.72–1.25) and 1.18, (95% confidence interval 0.90–1.57), respectively. The results suggest that transplant recipients can have similar screening protocols to those for the general population. Patient summary: Using database results for transplant recipients, we investigated their risk of developing aggressive prostate cancer after transplantation. We found that having a transplant did not increase the risk of aggressive prostate cancer. This work suggests that transplant recipients are unlikely to benefit from more rigorous screening protocols than those for the general population.http://www.sciencedirect.com/science/article/pii/S2666168322000520Prostatic neoplasmsImmunosuppressionTransplantProstate cancer |
| spellingShingle | Zorawar Singh Sarah K. Holt John L. Gore Yaw A. Nyame Jonathan L. Wright George R. Schade Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation European Urology Open Science Prostatic neoplasms Immunosuppression Transplant Prostate cancer |
| title | Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation |
| title_full | Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation |
| title_fullStr | Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation |
| title_full_unstemmed | Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation |
| title_short | Aggressive Prostate Cancer at Presentation Following Solid Organ Transplantation |
| title_sort | aggressive prostate cancer at presentation following solid organ transplantation |
| topic | Prostatic neoplasms Immunosuppression Transplant Prostate cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2666168322000520 |
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