Abstract: SA-PO051
Post-Transplant Survival Among Patients with Pretransplant Treatment for Prostate Cancer
Session Information
- Transplantation: Clinical Outcomes
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Sarabu, Nagaraju, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
- Schiltz, Nicholas K., Case Western Reserve University, Cleveland, Ohio, United States
Background
Optimal pre-kidney transplant treatment and waiting time for transplant among patients with prostate cancer is unclear.
Methods
We studied male patients, 40 years or older, with ESRD who had Medicare claims for prostate cancer and two main types of treatment (radiation and prostatectomy) utilizing USRDS (United States Renal Data System). We stratified patients into three categories based on waiting time to transplant from the time the prostate cancer was treated (0-2, 2-5, >5 years). We used Kaplan-Meier method to compare post-transplant survival among the strata. We used Cox proportional hazards model to assess relative risks of death between the groups.
Results
There were a total of 920 patients who had kidney transplants with prior history of treatment for prostate cancer. Figure 1a shows KM curves, stratified by waiting time (p-values = <0.01). Compared to 0-2 years of waiting time, 2-5 years had 13% higher likelihood of death (HR: 1.13, 95% CI:0.88-1.44) and >5 years had 73% higher likelihood of death (HR: 1.73, 95% CI:1.30-2.3). Prostatectomy was associated with a better post-transplant survival than radiation (Figure 1b).
Conclusion
Prostatectomy and kidney transplant without significant delay may be optimal choices for patients with prostate cancer and eligible for kidney transplant.
Kaplan Meier survival curves for patients, stratified by waiting time (1a) and type of treatment (1b)