INTRODUCTION: To assess the prevalence of prostate cancer (PCa) in men receiving immunosuppressive medications undergoing transrectal ultrasound guided (TRUS) prostate biopsy.

METHODS: A total of 468 TRUS prostate biopsies from 368 men were studied. All men received one or more systemic immunosuppressive medications including azathioprine, cyclosporine, mycophenolate mofetil, sirolimus, everolimus, and tacrolimus. Analyzed variables included age, race, family history of PCa, PSA, digital rectal examination (DRE) finding and prostate volume at time of biopsy. Simple descriptive analysis were performed to assess the overall prevalence of PCa and clinically significant prostate cancer (more than or equal to Gleason 7).

RESULTS: The mean age was 64.4 years (SD± 8.3). 13.1% (47/360) of men self-identified as African American and 7.9% (29/367) had a family history of prostate cancer. At the time of biopsy, the median PSA was 5.3 ng/ml (IQR 4-8), 6% of men had abnormal DRE, median prostate volume was 36cc (IQR 27-48) and the median number of cores sampled was 12 (IQR 10-12). Among 468 biopsies, the PCa detection rate was 44.9 % (210/468), with 25.4% (119/468) of the biopsies demonstrating clinically significant cancer. At initial biopsy, the overall PCa was 46.0% (162/352) and clinically significant disease was 26.4% (93/352). In comparison, the rates of overall and clinically significant PCa were 41.4% (48/116) and 22.4% (26/116), respectively, on repeat biopsies.

CONCLUSIONS: There is limited data on the rates of PCa diagnosis among immunocompromised men with clinical indications for biopsy. The prevalence of diagnosed PCa at time of TRUS biopsy ranged from 41-46% with more than 50% of those men diagnosed with clinically significant disease. Further studies of pathologic findings at radical prostatectomy are warranted in this population.

CITATION INFORMATION: Eltemamy M., Elshafei A., Salah A., Nyame Y., Arora H., Wee A., Krishnamurthi V., Jones S. Prostate Cancer Characteristics in Men on Immunosuppressive Medications Am J Transplant. 2017;17 (suppl 3).

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