Among older men with prostate cancer, an organ transplant is associated with higher overall mortality, but not prostate cancer-specific mortality (PCSM), according to a study published online in the Journal of the National Cancer Institute.

Stanley L. Liauw, M.D., from the University of Chicago, and colleagues used Surveillance, Epidemiology, and End Results-Medicare-linked data to identify 163,676 men aged ≥66 years who were diagnosed with nonmetastatic prostate cancer. History of solid organ transplant was identified using diagnosis or procedure codes, and outcomes were compared to a propensity score-matched cohort of nontransplanted men matched by age, race, region, year, T-stage, grade, comorbidity, and cancer therapy.

The researchers identified 620 men with transplant ≤10 years before (320 men) or five years after (300 men) prostate cancer diagnosis and matched them to 3,100 men. At 10 years, overall mortality was 55.7 percent and PCSM was 6 percent in the transplant cohort versus 42.4 percent (P < 0.001) and 7.6 percent (P = 0.70), respectively, in the nontransplant cohort. In adjusted models, there was no difference in PCSM for transplanted men (hazard ratio, 0.88; 95 percent confidence interval, 0.61 to 1.27; P = 0.70). Among 334 transplanted men with well-differentiated or moderately differentiated "low-risk" prostate cancer, PCSM was similar for treated and untreated men (hazard ratio, 0.92; 95 percent confidence interval, 0.47 to 1.81).

"These findings suggest men with prostate cancer and previous or future organ transplantation should be managed per usual standards of care, including consideration of active surveillance for low-risk cancer characteristics," the authors write.

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