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

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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Intraductal carcinoma of the prostate in prostate biopsy samples: correlation with aggressive pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer

Asian Journal of Andrology ◽

10.4103/aja.aja_117_19 ◽

2020 ◽

Vol 22 (5) ◽

pp. 519 ◽

Cited By ~ 1

Author(s):

Peng-Fei Shen ◽

Hao Zeng ◽

Sha Zhu ◽

Jin-Ge Zhao ◽

Jun-Ru Chen ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Prostate Biopsy ◽

Prognostic Value ◽

Intraductal Carcinoma ◽

Pathological Features ◽

Carcinoma Of The Prostate ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

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The presence of intraductal carcinoma of the prostate in needle biopsy as a prognostic parameter for prostate cancer patients with distant metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.7_suppl.237 ◽

2015 ◽

Vol 33 (7_suppl) ◽

pp. 237-237

Author(s):

Masashi Kato ◽

Toyonori Tsuzuki ◽

Kyosuke Kimura ◽

Naoto Sassa ◽

Yasushi Yoshino ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Distant Metastasis ◽

Needle Biopsy ◽

Univariate Analysis ◽

Intraductal Carcinoma ◽

Prognostic Parameter ◽

Carcinoma Of The Prostate ◽

The Core ◽

Gleason Pattern

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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Intraductal carcinoma of the prostate in prostate biopsy samples: Correlation with pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.123 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 123-123

Author(s):

Sha Zhu

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Cancer Patients ◽

Prostate Biopsy ◽

Prognostic Value ◽

Pathological Features ◽

Carcinoma Of The Prostate ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

123 Background: Intraductal carcinoma of the prostate (IDC-P) is a biologically aggressive form of prostate cancer. We investigated the correlation between IDC-P in prostate biopsy samples (Pbx) and several pathological features after radical prostatectomy (RP), also its prognostic value in high-risk prostate cancer patients. Methods: Totally, 455 patients diagnosed with PCa during 2010 to 2017 in West China Hospital were included in this study. Chi-squared test and binary logistic regression were used in discovering the correlation between IDC-P and post-RP pathological features. Kaplan Meier curve, log-rank test, Cox’s proportional hazards model and C-index were applied in the investigation of the prognostic value of IDC-P on 418 high-risk patients. Results: The detection rate of IDC-P in Pbx is 7.91%. IDC-P was an independent predictor of SVI ( p= 0.014), EPE ( p< 0.001), cT stage ( p= 0.001), PSM of urethra end ( p= 0.042). Patients with IDC-P in PBx specimens manifested poorer BFS than those without IDC-P ( p< 0.001), and IDC-P pattern 2 (HR: 4.429, p= 0.020) was associated with worse prognosis than IDC-P pattern 1 (HR: 3.225, p= 0.047). Further analyses also demonstrated that the addition of IDC-P in several nomograms could improve their C-index. Conclusions: IDC-P is associated with several post-RP pathological features after radical prostatectomy. Also, IDC-P can effectively predict the patients’ BFS, and the addition of it can increase the C-index of several nomograms.

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