MANAGEMENT OF PROSTATE CANCER IN KIDNEY TRANSPLANT RECIPIENTS.

Kidney transplantation is the treatment of choice in eligible patients with end-stage kidney disease. Prostate cancer (PC) is the second most common cancer in men worldwide. The prevalence of chronic kidney disease worldwide is 13.4%. The management of localized PC in these patients is challenging due to immunosuppressive therapy and pelvic graft localization. High graft and recipient survival rates have resulted in higher numbers of these patients in our everyday practice. A retrospective analysis of male patients who had undergone kidney transplantation at our center between 2002 and 2022 and were diagnosed and treated for PC was performed. We analyzed the incidence, treatment methods, and follow-up of PC patients in this population. A total of 1079 male patients were transplanted. PC was diagnosed in 12 patients (8 after and 4 before transplantation). The incidence of PC was 1.11%. Radical prostatectomy was performed in 11 patients, and one patient was treated with radical radiotherapy. Eleven patients had stable graft function; 1 graftectomy was performed, unrelated to PC. Three patients were indicated for salvage radiotherapy, one is in process for prostate-specific membrane antigen positron emission tomography (PSMA PET CT), and 7 patients are in follow-up and without recurrence. Radical prostatectomy is a safe treatment method for localized PC in kidney transplant recipients, which does not impair graft function and survival.

Anthropometrical characteristics of the population of the island of Rab.

The paper presents the results of the population structure research on the inhabitants of the Island of Rab by the analysis of anthropometric, continuous characteristics (morphological variables of head and body) on the representative sample of 601 adult persons (aged 18-75 years) from the settlements Banjol, Barbat, Lopar, Rab and Supetarska Draga (Figure 1). The aim was to investigate the possibility to confirm the existence of population groupings or divisions in one geographically limited area based on the analysis of continuous anthropometric variables. In other words, the purpose is to investigate the structure of the inhabitants in order to contribute to the explanation of its microevolution. The performed analysis shows partial anthropometric variability of the present day population that is confirmed by a series of biostatistics analyses. The analysis includes continuous (quantitative) characteristics, 36 anthropometric body variables and 14 anthropometric head variables. Heterogeneity among the groups of examinees is evaluated for separate phenotypic characteristics in order to obtain the data on the inhabitants' microevolution. The estimation performed on the total of 36 analyzed body variables showed the existence of statistically significant heterogeneities for 13 variables in men and for women in 8. By descriptive statistic procedures and by the estimation of heterogeneity, in space of the head related phenotypic characteristics, heterogeneity was found for 7 characteristics in men and for 5 in women. Discrimination analyses show that certain heterogeneity exists in some investigated continuous characteristics among individual populations. The results of the biological distances evaluation among the populations of the Island of Rab point to the separation of some populations, primarily of the inhabitants of Lopar.

Evolution of the clinical presentation and outcomes after radical prostatectomy for patients with clinically localized prostate cancer--changing trends over a ten year period.

We demonstrate the evolution of the clinical presentation and outcomes for patients with clinically localized prostate cancer (PC) treated with radical retropubic prostatectomy (RRP) at our department, emphasizing epidemiologic significance of changes during the 10-year period. We assessed the annual trends for changes in patients age, preoperative prostate specific antigen (PSA), preoperative versus postoperative stages and Gleason grades, organ confined status and surgical margin status. A total of 488 RRPs were performed from January 1996 to December 2005 with the annual frequency increased from 8 to 129 (1512.5%). Mean patient age increased from 61.5 to 66.12 years in 2005, with the percentage of men aged more than 70 years increased from 12.5 to 26.5%, respectively. The detection of PC based solely on pathological PSA levels (as indication for prostate biopsy) rose impressively from 25.5 to 70% and the rates of postoperative organ-confined disease also increased significantly from 25 to 74.7%. Mean preoperative PSA decreased from 16.7 to 9.89 ng/mL. On the contrary, there was an increase in percentage of patients with preoperative PSA values ranging from 4 to 10 ng/mL (from 20 to 65.4%). Positive surgical margin rate decreased from 49.4 to 25% and percent of patients receiving neoadjuvant therapy decreased from 78.5 to 5.4%. Proportion of patients who were undergraded decreased from 75.1 to 31.7%. The rates of understaging have remained relatively stable over the years. During the study period, PC was increasingly detected by prostate biopsy on the basis of a pathological PSA level only and shifted significantly to more organ-confined stages with more favourable outcomes for pathological variables due to a more accurate assessment of clinical stage prior to surgery, reduced use of neoadjuvant therapy and improved surgical technique. Our data also argue strongly that routine PSA testing should be expanded and not restricted.