Der Urologe

, Volume 45, Issue 1, pp 32–37 | Cite as

Diagnostik und Therapie des Prostatakarzinoms nach Nierentransplantation

  • A. Wicht
  • A. Hamza
  • H. Loertzer
  • M. Dietl
  • H. Heynemann
  • P. Fornara
Leitthema

Zusammenfassung

In den Industrieländern ist eine stetig steigende Anzahl von Patienten mit Prostatakarzinom (P-Ca) und terminaler Niereninsuffizienz bzw. Prostatakarzinom nach Nierentransplantation (NTX) zu verzeichnen. Die Daten von Penn et al. zeigen zwar eine erhöhte Inzidenz für das Prostatakarzinom nach NTX, das ist aber eher auf ein intensiveres Screening zurückzuführen. Die einhellige Meinung ist, dass ein erhöhtes Prostatakarzinomrisiko nach NTX nicht besteht. Auch bei einem nierentransplantierten Patienten ist bei lokal begrenztem Tumor eine Therapie unter kurativer Zielsetzung anzustreben.

Durch die Nierentransplantation werden die operativen Zugangswege (retropubisch oder perineal) nicht eingeschränkt. Nicht lokal begrenzte Tumoren werden entsprechend allgemein gültiger Empfehlungen zur Behandlung des P-Ca therapiert. Zusätzlich erscheint eine Reduktion bzw. Umstellung der Immunsuppression vor dem Hintergrund aktueller Literaturanalyse sinnvoll. Die Etablierung eines bundesweiten (optimaler: europaweiten) Tumorregisters speziell für Patienten vor und nach einer Organtransplantation ist erforderlich.

Schlüsselwörter

PSA Prostatakarzinom Niereninsuffizienz Dialyse Nierentransplantation 

Diagnostics and treatment of prostate cancer after kidney transplantation

Abstract

The number of patients with prostate cancer and end-stage renal disease or prostate cancer following kidney transplantation has continuously increased in industrialized countries. According to the data generated by Penn et al. a higher incidence of prostate cancer following kidney transplantation can be seen but is probably due to a more intense screening of the recipients. It is rather a common opinion that no elevated risk of prostate cancer following kidney transplantation exists.

In patients with strictly localized prostate cancer curative treatment should be the aim also after kidney transplantation. Kidney transplantation does not interfere with surgical access to the prostate gland (retropubic or perineal). Nonlocal tumors of the prostate should also be treated following the general recommendations regarding prostate cancer. Looking at the current literature a reduction or change of immunosuppression seems reasonable. It is necessary to establish a nationwide (or even European) cancer register, especially for patients before and after transplantation.

Keywords

PSA Prostate cancer Renal failure Kidney dialysis Kidney transplantation 

Notes

Interessenkonflikt:

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  • A. Wicht
    • 1
  • A. Hamza
    • 1
  • H. Loertzer
    • 1
    • 2
  • M. Dietl
    • 1
  • H. Heynemann
    • 1
  • P. Fornara
    • 1
  1. 1.Klinik und Poliklinik für UrologieMartin-Luther-Universität Halle-WittenbergHalle/Saale
  2. 2.Klinik und Poliklinik für UrologieMartin-Luther-Universität Halle-WittenbergHalle/Saale

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