RESUMO
Objectives: The incidence of prostate cancer in renal transplant recipients (RTRs) is increasing, but few data are available in the literature. In this study, we reviewed the 25-year experience in the management of prostate cancer after kidney transplantation at the Florence Transplant Centre. Methods: We retrospectively reviewed the data from 617 RTR male patients who underwent renal transplantation at our institute between July 1996 and September 2016. Data regarding demographics, renal transplantation, prostate cancer and immunosuppressive treatment were analyzed. The probability of death was estimated by using the Kaplan-Meier method and differences between patients' groups were assessed by the log-rank test. Results: From July 1991 to September 2016, 617 kidney transplantations of male patients were performed at our institute. Among these, 20 patients were subsequently diagnosed with prostate cancer accounting for a cumulative incidence of 3.24%. After a median follow-up of 59 months, 10 patients underwent radical prostatectomy whereas 10 patients underwent primary radiotherapy. A biochemical recurrence was identified in five (25%) patients while a fatal event occurred in 11 (55%) patients. Univariate Cox regression showed that the basal value of PSA >10 ng/ml was the only significant factor negatively affecting the survival of patients. Conclusions: Standard treatments can be proposed to RTR with satisfactory results on both post-operative and oncological outcomes. Further studies are needed to address the issue of prostate cancer screening based on PSA levels and the optimal management of prostate cancer in RTRs.
RESUMO
We present a single-institution experience reporting the efficacy and safety of docetaxel, administered as first-line chemotherapy, in castration-resistant prostate cancer (CRPC), focusing on patients and treatment parameters. From November 2004 to January 2012, 51 patients received chemotherapy with docetaxel. With a mean follow-up time (from the beginning of CHT) of 1.6 years (range 0.1-5.1 years), 35 patients (68.6%) died for prostate cancer and 48 patients (94.1%) showed progression of the disease. Five factors influenced overall survival: nodal status at diagnosis, neoadjuvant hormonal therapy, number of cycles of docetaxel administered, schedule of docetaxel and ECOG performance status before starting chemotherapy.