Surgery for localized prostate cancer after renal transplantation

OBJECTIVE: To investigate the feasibility of perineal radical prostatectomy (RP) in renal transplant recipients with localized prostate cancer. PATIENTS AND METHODS: The study comprised seven consecutive renal transplant patients who had a perineal RP between May 1991 and February 2004. All available clinicopathological data were reviewed. RESULTS: All seven patients successfully tolerated RP with no major complications. The mean (SD, range) age at surgery was 62.3 (2.5, 55-74) years and the mean interval from renal transplant to RP 86.5 (25.25, 24-192) months. There was no evidence of increased blood loss, operative duration, transfusion requirement, hospital stay or deterioration of graft function. The presence of an allograft did not alter the surgical approach or management of the patients after RP. The mean follow-up was 22 (2-130) months and all seven patients were followed. One patient had evidence of biochemical recurrence with no radiographic evidence of metastatic disease. Serum prostate-specific antigen was undetectable in the remaining patients. CONCLUSION: A perineal RP in renal transplant recipients for treating localized prostate cancer offers many advantages over other treatments.