title: Radical retropubic and perineal prostatectomy for clinically localised prostate cancer in renal transplant recipients.
abstract: OBJECTIVE
  To analyse the functional and oncological outcome of consecutive renal-transplant recipients (RTRs) with clinically localised prostate cancer who underwent radical retropubic (RRP) or perineal (RPP) prostatectomy.
  
  
  METHODS
  Between January 2000 and July 2011 16 patients underwent RRP (group 1) and seven RPP (group 2). In all, 200 consecutive non-RTRs served as the control group, of whom 100 each underwent RRP and RPP, respectively. The mean (range) interval between renal transplantation and RP was 95 (24-206) months, the PSA at the time of diagnosis was 4.5 (3.0-17.5) ng/mL, and the mean patient age was 64 (59-67) years.
  
  
  RESULTS
  The mean follow-up was 39 (RRP) and 48 months (RPP). There was no deterioration in graft function. In group 1, 13 and three patients had pT2a-cpN0 and pT3a-bpN0 prostate cancer, respectively, with a Gleason score of 6, 7 and 8 in 11, three and one patients, respectively. In group 2, three and four patients had pT2a-c and pT3a-b disease, respectively, with a Gleason score of 6 and 7 in two and five, respectively. In both groups one patient had a positive surgical margin and was followed expectantly, and all patients have no evidence of disease. Wound infections developed more often in the RPP group (29% vs. 7%), but there were no Clavien grade III-V complications. All patients achieved good continence, and two need one pad/day.
  
  
  CONCLUSIONS
  RRP and RPP are suitable surgical treatments for prostate cancer in RTRs. RRP might be preferable, as it has the advantage of simultaneous pelvic lymphadenectomy and a lower risk of infectious complications.
authors.affiliation: Department of Urology, RWTH University Aachen, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Heidenreich
authors.affiliation: Department of Urology, RWTH University Aachen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Pfister
authors.affiliation: Department of Urology, RWTH University Aachen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Thissen
authors.affiliation: Department of Urology, RWTH University Aachen, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Piper
authors.affiliation: Department of Urology, RWTH University Aachen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Porres
keywords: Immunosuppression; PLND, pelvic lymph-node dissection; Prostate cancer; RP, radical prostatectomy; RPP, perineal RP; RRP, retropubic RP; RT, renal transplantation; RTR, renal-transplant recipient; Radical prostatectomy; Renal transplantation; Robot assisted prostatectomy