*Purpose: Optimal treatment and waiting time for patients with prostate cancer awaiting kidney transplant is unclear.

*Methods: We studied male patients, 40 years or older, with ESRD who were Medicare beneficiaries and had Medicare claims for prostate cancer and two main types of treatment (radiation and prostatectomy) utilizing USRDS (United States Renal Data System) during the study period 1999-2012. We stratified them into three categories based on waiting time to transplant from the time the prostate cancer was treated (0-2, 2-5, >5 years). Propensity scoring was used to adjust for baseline variables, Kaplan-Meier methods to compare post-transplant survival and Cox proportional hazards models to assess relative risks of death between the groups.

*Results: A total of 920 patients who had kidney transplants with prior history of curative treatment for prostate cancer were identified. 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). Prostatectomy had a 60% less hazard of death compared to radiation (HR: 0.4, 95%CI: 0.33-0.49).

*Conclusions: Prostatectomy and kidney transplant without significant delay may be optimal choices for patients with prostate cancer who are eligible for kidney transplant.

« Back to 2019 American Transplant Congress