Prognostic significance of the presence of intraductal carcinoma of the prostate and bone metastasis in needle biopsy for prostate carcinoma patients with Grade Group 5

237 Background: The presence of intraductal carcinoma of the prostate (IDC-P) is an adverse prognostic factor for prostate-specific antigen (PSA) failure, progression-free survival, and cancer-specific survival (CSS) in localized prostate cancer patients. However, there is no data indicating whether the presence of IDC-P can influence outcome in prostate cancer patients with distant metastasis at presentation. We aimed to evaluate whether IDC-P in needle biopsies is also an adverse prognostic parameter for CSS in prostate cancer patients with distant metastasis. Methods: We retrospectively evaluated 159 prostate cancer patients with distant metastasis who presented at the hospitals that the authors are affiliated with between 2002 and 2012 and reviewed the slides prepared from prostate needle biopsy specimens. Data on the patient age, performance status, clinical T stage, serum PSA, C-reactive protein, alkaline phosphatase (ALP), hemoglobin (Hb), albumin, serum calcium, biopsy Gleason score (> 8 or not), the presence of Gleason pattern 5, the percent of the core involved with cancer, and the maximum percent of a core involved with cancer were analyzed. Patient characteristics were analyzed using the Fisher's exact test. Multivariate Cox proportional hazard regression models were developed to predict CSS. Results: Patient median age was 73 years (range 47–90 years). The median serum PSA was 290 ng/mL (range 4.18–10,992 ng/mL). The median follow-up period was 36 months (range 3–120 months). IDC-P component was detected in 103 (64.8%) patients. There were 82 patients who died of the disease and 6 patients who died of other causes. Using univariate analysis, IDC-P (p = 0.0001), the presence of Gleason pattern 5 (p = 0.005), the percent of the core involved with cancer (p = 0.002), Hb (p = 0.001), and high ALP (p = 0.002) were all shown to be significantly associated with CSS. In the multivariate analysis, only IDC-P (p = 0.016; hazard ratio, 2.187) was significantly associated with CSS. Conclusions: The presence of IDC-P in needle biopsy is a prognostic parameter for CSS in patients with distant metastasis at presentation.

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Radical prostatectomy (RP) findings in cases with only intraductal carcinoma of the prostate (IDC-P) on needle biopsy

International braz j urol ◽

10.1590/s1677-55382010000200021 ◽

2010 ◽

Vol 36 (2) ◽

pp. 234-235

Author(s):

Athanase Billis

Keyword(s):

Radical Prostatectomy ◽

Needle Biopsy ◽

Intraductal Carcinoma ◽

Carcinoma Of The Prostate

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Contemporary Grading of Prostate Cancer: The Impact of Grading Criteria and the Significance of the Amount of Intraductal Carcinoma

Cancers ◽

10.3390/cancers13215454 ◽

2021 ◽

Vol 13 (21) ◽

pp. 5454

Author(s):

Vasiliki Tzelepi ◽

Ioanna Maria Grypari ◽

Souzana Logotheti ◽

Stavros Kontogiannis ◽

Panagiotis Kallidonis ◽

...

Keyword(s):

Prostate Cancer ◽

Prognostic Significance ◽

Intraductal Carcinoma ◽

Grading System ◽

Grade Group ◽

Prognostic Parameter ◽

Therapeutic Decisions ◽

Histopathologic Analysis ◽

The Impact ◽

Potential Area

(1) Background: Prognostic grade group (PGG) is an important prognostic parameter in prostate cancer that guides therapeutic decisions. The cribriform pattern and intraductal carcinoma (IDC) are two histological patterns, that have additional prognostic significance. However, discrepancies exist regarding the handling of IDC according to the guidelines published by two international genitourinary pathology societies. Furthermore, whether, in addition to its presence, the amount of IDC is also of importance has not been studied before. Lastly, the handling of tertiary patterns has also been a matter of debate in the literature. (2) Methods: A total of 129 prostatectomy cases were retrieved and a detailed histopathologic analysis was performed. (3) Results: Two cases (1.6%) upgraded their PGG, when IDC was incorporated in the grading system. The presence and the amount of IDC, as well as the presence of cribriform carcinoma were associated with adverse pathologic characteristics. Interestingly, in six cases (4.7%) there was a difference in PGG when using the different guidelines regarding the handling of tertiary patterns. In total, 6.2% of the cases would be assigned a different grade depending on the guidelines followed. (4) Conclusions: These findings highlight a potential area of confusion among pathologists and clinicians and underscore the need for a consensus grading system.

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Presence of intraductal carcinoma of the prostate on needle biopsy as a prognostic factor for prostate cancer in radical prostatectomy patients.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.4_suppl.268 ◽

2014 ◽

Vol 32 (4_suppl) ◽

pp. 268-268

Author(s):

Masashi Kato

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Needle Biopsy ◽

Univariate Analysis ◽

Intraductal Carcinoma ◽

Carcinoma Of The Prostate ◽

High Risk Prostate Cancer ◽

Gleason Pattern ◽

Risk Prostate Cancer

268 Background: Intraductal carcinoma of the prostate (IDCP) is seen with widely invasive, biologically aggressive prostate cancer. A recent study has shown this morphologic pattern is useful for prognostication of biochemical recurrence after radical prostatectomy, whereas there is no paper to report biopsy finding of IDCP to be a positive predictor of progression-free survival (PFS) and cancer-specific survival (CSS). Methods: This retrospective study included men with high-risk prostate cancer treated with radical prostatectomy between 1991 and 2005, and we reviewed slides of biopsy samples. Presence of IDCP was defined using previously published diagnostic criteria by a single genitourinary pathologist. Analyzed factors included age, prostate-specific antigen (PSA), clinical T stage, higher biopsy Gleason score (bGS), presence of Gleason pattern five, and IDCP on biopsy samples. Finally, a total of 205 patients with high-risk prostate cancer were entered in our retrospective clinicopathological analysis. Results: Patient mean age was 68. Baseline characteristics included a PSA greater than 20 ng/ml at diagnosis in 122 cases (60%), clinical stage greater than T2 (cT) in 86 (42%), and bGS ³a8 in 150 (73%) in all patients. Follow-up period was 86 months on average. The presence of IDCP on needle biopsy was in 75 (37%). Forty-four patients showed clinical failure, and 20 patients died of the disease. Patients with IDCP showed a higher increased PSA level, higher increased bGS, and more advanced cT than those without IDCP (p < 0.0001). In univariate analysis, IDCP (p < 0.0001), cT (p < 0.0001), bGS (p = 0.0002), and presence of Gleason pattern five (p=0.004) were significantly associated with PFS; IDCP (p < 0.001) and cT (p = 0.02) were significantly associated with CSS. In multivariate analysis, IDCP (p< 0.0001; hazard ratio (HR), 3.574) and cT (p= 0.004; HR, 3.087) were significantly associated with PFS; IDCP (p = 0.001; HR, 8.405) and PSA level (p = 0.0044; HR, 2.920) were significantly associated with CSS. Conclusions: Presence of IDCP on needle biopsy can be a significant predictor of PFS and CSS when analyzing factors of biopsy samples in high risk prostate cancer.

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